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  • The Acute Surgical Abdomen Semiology

    Încărcat de

    Dona Teodor FC
    127 vizualizări9 pagini
    The document summarizes key subjective and objective clinical features that help diagnose an acute surgical abdomen. Pain is the most important subjective feature, with characteristics that can indicate conditions like perforation, obstruction, or pancreatitis. Vomiting, intestinal transit stoppage, and hiccups are other potential symptoms. Objective signs include fever, shock, respiratory issues, and specific inspection findings depending on the condition. Diagnostic tests like bloodwork, imaging, and procedures can further evaluate causes like bleeding, pancreatitis, bowel obstructions, or intra-abdominal injuries.

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    The Acute Surgical Abdomen Semiology corse

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    The document summarizes key subjective and objective clinical features that help diagnose an acute surgical abdomen. Pain is the most important subjective feature, with characteristics that can indicate conditions like perforation, obstruction, or pancreatitis. Vomiting, intestinal transit stoppage, and hiccups are other potential symptoms. Objective signs include fever, shock, respiratory issues, and specific inspection findings depending on the condition. Diagnostic tests like bloodwork, imaging, and procedures can further evaluate causes like bleeding, pancreatitis, bowel obstructions, or intra-abdominal injuries.

    Drepturi de autor:

    © All Rights Reserved
    Descărcați ca PPT, PDF, TXT sau citiți online pe Scribd
    Indicator pentru conținut neadecvat
    127 vizualizări9 pagini

    The Acute Surgical Abdomen Semiology

    Încărcat de

    Dona Teodor FC
    The document summarizes key subjective and objective clinical features that help diagnose an acute surgical abdomen. Pain is the most important subjective feature, with characteristics that can indicate conditions like perforation, obstruction, or pancreatitis. Vomiting, intestinal transit stoppage, and hiccups are other potential symptoms. Objective signs include fever, shock, respiratory issues, and specific inspection findings depending on the condition. Diagnostic tests like bloodwork, imaging, and procedures can further evaluate causes like bleeding, pancreatitis, bowel obstructions, or intra-abdominal injuries.

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    © All Rights Reserved
    Descărcați ca PPT, PDF, TXT sau citiți online pe Scribd
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    din 9

    THE ACUTE SURGICAL

    ABDOMEN SEMIOLOGY.
    PARACLINICAL FINDINGS
    I. SUBJECTIVE CLINICAL FEATURES

    1. Pain the most important!


    suddenly onset in a specific abdominal
    territory
    spreads all over
    is joined by another clinical features
    (abdominal tenderness, digestive reflex
    phenomena)
    Sudden onset brusc, extreme, like a knife stab
    perforation
    colic (obstruction)
    acute pancreatitis (bar pain)
    Pain headquarters
    epigastric (in perforated GDU)
    bar pain (AP)
    per umbilical region (enter mesenteric infarct)
    right iliac fosse (acute appendicitis)
    right or left iliac fosse (ectopic pregnancy)
    right hypochondria (acute colecistytis)
    fixed localisation (torsion syndrome)
    2. Vomiting

    reflex manifestation
    is present in almost all syndroms of ASA
    initial alimentary
    eventually bilious fecaloid
    soon upper obstruction
    time of onset
    late lower obstruction
    3. Stop of intestinal transit for stool and gases
    mechanical obstacle (volvulus, tumor, invagination)
    functional reflux peritonitis

    4. Hiccup
    reveals severe evolution of a peritoneal process.
    II. GENERAL FEATURES

    1. Fever
    2. Shock reflex (due the pain)
    - pallor
    - cold sweat
    - circulatory disorders
    toxical-septic
    - terous faccies
    - dry tongue
    eyes plugged in the eye socket
    3. Respiratory disorders tachypneea
    superficial breathing
    III. Objective clinical manifestations

    1. Inspection
    peritontis terous facies
    - dry skin
    - immobile patient
    - immobile abdomen towards
    respiratory movements of the chest
    intestinal obstruction protuberant abdomen
    - intestinal peristaltics
    are
    sometimes visible
    2. Percussion disappearance of flatteness in the
    pre-hepatic area (in perforation)
    3. Auscultation no peristaltic in evolutive
    peritonitis
    hydroaeric noiser hiperperistaltics

    in occlusion
    4. Digital rectal examination (DRE)
    tumors
    IDH
    empty rectal ampul (i.o.)
    foreign objects
    tension of Douglas bottom bag
    5. Digital vaginal examination (DVE)
    organ torsion
    ectopic pregnancy
    IV. PARACLINICS
    1. Ht. significant after 6-12h trow onset of bleeding
    2. Amylase
    3. WBC
    4. RADIOLOGY
    a. Native (no contrast substance)
    - standing
    - dorsal R / L decubitus
    - pneumoperitoneum
    - hydroaeric levels central (small bowel)
    peripheric (organ
    tube tipe in large
    bowel
    obstruction)
    b. Rx pelvis
    kidney
    chest
    c. Selective arteriography
    d. Urography
    e. Abdominal punction
    f. Ultrasound
    g. Diagnostic laparoscopy
    h. CT
    i. RMI

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