Acute abdominal pain

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Acute abdominal pain
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epidemiology

• Number one reason to visit an ED
• In 2006, 6.7 of ED visits 8.04 million patient
  encounters

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pathophys

• Visceral pain stretching of unmyelinated fibers
  that innervate the walls or capsules of organs
• crampy, dull, achy
• Organs are bilaterally innervated, so pain is
  perceived in the midline (appendix)

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• Parietal pain irritation of myelinated fibers
  that innervate the parietal peritoneum
• Can be localized
• Guarding and rebound
• Will prefer to not move.

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Clinical features

• Is the patient clinically ill?
• Vitals, appearance, age
• History
• Physical exam
• Auscultation
• Palpation
• Labs
• imaging

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treatment

• Analgesics
• Anti-emetics
• antibiotics

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Specials populations

• Women
• Ectopic pregnancy
• PID
• Elderly
• Underreport symptoms
• What is the most common surgical entity in
  elderly patients with abdominal pain?

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Post of population

• Ileus and early SBO
• C. diff

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reference

• Tintinalli, ch. 74