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Abdominal Emergencies | Causes & Management

Common causes of acute abdomen:

Bacterial contamination: infection in the bowel or peritonitis
Chemical irritation: leakage of blood or bile into wrong space
Peritoneal inflammation: bacterial, chemical or trauma
Bleeding: solid organ laceration. Abdominal cavity can hold 1500mL of blood before distention
Obstruction
Four life-threatening acute abdomens :

  • AMI
  • Ruptured Abdominal Aortic Aneurysm
  • Ruptured ectopic pregnancy (any woman age 12-50)
  • Ruptured viscus (any hollow organ)

Localized or diffuse pain: abdominal organs have receptors for pressure, but not for pain. Focused Physical Exam: Evaluate:

  • General appearance
  • Tenderness, guarding, rebound tenderness
  • Pulsating mass – AAA

Management and Treatment: 

  1. Maintain the airway
  2. Hi-flow O2
  3. Allow the patient to lie in a comfortable position
  4. Nothing by mouth
  5. Start in IV normal saline or LR
  6. Avoid pain meds that mask the symptoms
  7. Start IV line for normal saline or LR
  8. Monitor cardiac rhythm
  9. Prepare for vomit
  10. Consider AMI
  11. Transport gently but rapidly

 

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