appendix, ascending colon, small intestine, ovary, fallopian tube
small intestine, descending colon, ovary, fallopian tube
3 central areas of ABD
epigastric - above the umbilical area
periumbilical - around the umbilical area
suprapubic - above the pubic area
dull poorly localized pain that originates in the walls of hollow organs.
inflammation of the peritoneum, which lines the abdominal cavity
sharp, localized pain that originates in walls of the body such as skeletal muscles.
pain that originates in a region other than where it is felt.
ecchymosis in the periumbilical region
ecchymosis in the flank
Grey Turner’s sign
Gastrointestinal disease risk factors 5
1. Excessive alcohol consumption
2. Excessive smoking
3. Increased stress
4. Poor bowel habits
5. ingestion of caustic substances
3 types of GI pain
visceral , somatic, referred
Pain from hollow organs tends to be _______
vague and nondescript
Pain from solid organs tends to be ______
pain that originates in a region other than where it is felt
Patients with severe abd pain present as
still as possible in fetal position
An ominous sign is
If you ascultate the abdomen you must do it before
Highest priority when treating a patient with abdominal pain
Persistent abdominal pain lasting longer than 6 hours always
Upper GI bleed
bleeding within GI tract proximal to ligament of Treitz
Ligament of Treitz
ligament that supports the duodenojejunal junction
esophageal laceration, usually secondary to vomiting
dark, tary, foul smelling still indicating the presence of partially digested blood
three lumen tube used in treating esophageal bleeding
swollen vein of the esophagus
pertaining to the flow of blood into the liver
degenerative disease of the liver
These should be avoided in prehospital treatment cases of suspected esophageal varices 2
Combitube, nasogastric tube
– sudden onset of inflammation of the stomach and intestines
bright red blood in the stool
nonacute inflammation of the GI mucosal
Most cases of gastroenteritis are _______
erosion caused by gastric acid
condition that causes the stomach to secrete excessive amounts of hydrochloric acid and pepsin
Lower GI bleeding
bleeding in the GI tract distal to the ligament of Treitz.
Major causes of lower GI hemorrhage 4
2 colon lesions
3 rectal lesions
4 inflammatory bowel disorder
Lower GI diseases 5
1. ulcerative colitis
2. Crohn’s disease
5. Bowel obstruction
ulcerative colitis spread throughout the entire colon
ulcerative colitis limited to the rectum
acute pain associated with cramping or spasms in the abdominal organs
Patients with ulcerative colitis are increased risk for developing ______
idiopathic inflammatory bowel disorder associated with the small intestine
– inflammation of diverticula
presence of diverticula, with or without associated bleeding
small outpouchings in the mucosal lining of the intestinal tract
Most common presentation of diverticulitis is ___
colicky pain usually on lower left side with low grade fever, nausea, vomiting, and tenderness
small mass of swollen veins in the rectum
Hemorrhoids rarely cause _______
blockage of the hollow space within the intestines
protrusion of an organ through its protective sheath
condition that occurs then part of an intestine slips into the part just distal to itself
twisting of the intestine on itself
union of normally separate tissue surfaces by a fibrous band of new tissue
area of dead tissue caused by lack of blood
inflammation of the vermiform appendix at the juncture of the large and small intestine
Is eventually treated in the operating room more frequently than any other abdominal emergency
common site of pain from appendicitis, 1 to 2 inches above the anterior iliac crest in a direct line with the umbilicu
Gall bladder pain occurs in which quadrant
- How it feels
RUQ or epigastrum
Acute pancreatitis is most often due to
alcohol abuse or gall stones
Possible caused of LUQ pain
Possible causes of LLQ pain
- ectopic pregnancy
- ovarian torsion
Possible causes of RUQ
- Cholecystitis - refers to a painful inflammation of the gallbladder's wall.
- Hepatitis C - is a viral disease that leads to swelling (inflammation) of the liver
Chlamydia - is a disease caused by the bacteria Chlamydia trachomatis. It is most commonly sexually transmitted
Possible causes of RLQ pain
- ectopic pregnancy -pregnancy implants
outside the uterine cavity
Possible causes epigastric pain
- drug usage
- lactase deficiency
- pancreatic cancer
Possible causes for Periumbilical pain
- mesenteric adenitis
swollen abdominal lymph nodes
– inflammation of peritoneum that can be due to the spilling of organ contents into the space
Six major causes of upper GI bleed
1. peptic ulcer disease – erosions caused by gastric acid.
2. Gastritis - inflammation of the lining of the stomach, and has many possible causes. The main acute causes are excessive alcohol consumption or prolonged use of NSAIDs such as aspirin ibuprofen.
3. varix rupture – swollen vein of the esophagus that ruptures
4. Mallory-Weiss tear - occurs in the mucus membrane of the lower part of the esophagus or upper part of the stomach, near where they join. The tear may bleed. It is usually caused by forceful long term vomiting or coughing.
5. Esophagitis - any inflammation, irritation, or swelling of the esophagus. It is frequently caused by the backflow of acid-containing fluid from the stomach to the esophagus, a condition called gastroesophageal reflux.
AKA gall bladder attack is inflammation of the gall bladder and is usually caused by gall stones.
– inflammation of the colon caused by infection, poor blood supply, or autoimmune reactions. Its most common symptoms are abdominal pain and diarrhea
enlarged veins of esophageal varices form when blood flow to your liver is slowed. Caused by portal pressure (portal hypertension) Often these varices rupture and hemorrhage
What is the management of upper GI bleed?4
- place patient in left lateral recumbent or high semi-Fowler’s position to prevent aspiration.
- give high flow, high concentration oxygen by non rebreather.
- establish 2 large bore IVs, one with blood tubing for possible transfusion and volume replacement 0.9 percent NaCl. - you can give a 20cc/kg fluid bolus to begin treating hemorrhagic hypovolemia
What is the management of lower GI bleed?5
- watch airway and oxygenation status closely
- if hypoventilation or inadequate respiration develop, give high flow oxygen by nonrebreather or positive pressure ventilation.
- establish IV and give fluid based on patients hemodynamic status
- place in a comfortable position and offer psychological support and transport.
- consider use of PASG if hemodynamic instability develops during transport.