Acute Abdomen Flashcards Preview

Geriatrics > Acute Abdomen > Flashcards

Flashcards in Acute Abdomen Deck (18)
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1
Q

Challenge of Diagnosis

A

History confounded by stoicism, alterations in pain perception, memory deficits, communication problems, or mental status changes
Physical exam unreliable: 80% no rigidity, 50% afebrile
Check potential hernia sites
Less abdominal inflammatory response
Ancillary testing unreliable
CT & US must be used liberally

2
Q

Biliary Tract Disease

A

Most common cause of surgery in the elderly

“Biliary colic” replaced by vague abdominal complaints

3
Q

Diagnosis of Biliary Tract Disease in the Elderly

A
15% no epigastric or RUQ pain
5% no pain at all
40% normal WBC
10% afebrile
90% ultrasound diagnostic
4
Q

Appendicitis

A

Etiology: gallstones
Pain is usually absent
Pain when present is vague, PE unremarkable

5
Q

Signs of Appendicitis

A
Non-specific
Tachycardia
Hypotension
Tachypnea
Confusion
6
Q

Symptoms of Acute Diverticulitis

A

LLQ pain
Tenderness
Moderate abdominal distension
Moderate temperature elevation

7
Q

Diagnosis of Acute Diverticulitis

A

CT scan

8
Q

PUD

A

1/3 pain absent
Pain: vague, poorly localized
Symptoms: systemic & related to blood loss

9
Q

Typical Presentation of AAA Rupture

A

Hypotension
Abdominal pain
Back pain

10
Q

Key Finding of AAA

A

Enlarged, tender aorta

11
Q

Beware of ______ in the Elderly

A

Renal colic symptoms
Labeling hypotension as vagal
Atypical location of abdominal pain

12
Q

Diagnosis of AAA

A

Ultrasound

CT with contrast in stable patient

13
Q

Ischemic Bowel Presentation

A

Severe, visceral pain out of proportion with physical exam findings in a patient with risk factors

14
Q

Treatment for Ischemic Bowel

A

Early angiography

15
Q

Cause of Ischemic Bowel

A

SMA embolus
SMA thrombosis
Venous thrombosis
Non-occlusive

16
Q

Risk Factors for Ischemic Bowel

A
A. fib
Recent MI
CAD
Low flow states
Hypercoaguable states
Low cardiac output (CHF, sepsis, digoxin, hypovolemia)
17
Q

Causes of Mechanical Obstruction

A
Adhesions
Hernias
Appendicitis
Malignancy
Volvulus
Diverticulitis
AAA
18
Q

Abdominal Pain in the Elderly

A

Difficult & dangerous disease
Investigate & manage aggressively
Maintain a high level of suspicion