Beruflich Dokumente
Kultur Dokumente
Abdomen
By :
Raisa Cesarda
Rifa Fauzia
Preseptor :
Anatomy
DEFINITION
Acute Abdomen is clinics due to the
gravity of the situation in the abdominal
cavity which usually occurs suddenly with
pain as the primary complaint
Abdominal pain
Identification of abdominal pain include:
- Types of pain,
- nature of pain,
- onset of pain,
-Location of pain,
Type of pain
Visceral pain
Parietal pain
Referred pain
Nature of pain
Referred pain
Colic Pain
Onset of pain
seconds)
Appendicitis
Perforated ulcer
hours)
Strangulated hernia
Mesenteric infarction
Strangulated hernia
Chronic pancreatitis
Volvulus
aneurysm
Intussusception
Acute pancreatitis
Mesenteric lymphadenitis
Billliary colic
cyst
Diverticulitis
Pulmonary embolism
Clinical Assesment
OTHER HISTORY
Post medical history
Post surgical history
Family history : Malignancy or inflamatory bowel
disease
Physical Examination
General Appearance
- General Conditions
- Mood: Anxious ,Communicable
- Mobility
- Color: pallor, Flushing, Jaundice, Cyanosis
Vital Signs :
Temperature
Pulse rate
Blood Pressure
Respiratory rate
Physical Examination
Cardiopulmonary examination
Abdomen examination
Inspection
-movement: visible peristalsis
- The scar on the abdomen
- Abdominal distention
-Flatus
-Fluid
-Fetus
Erythema or discolouration
a. Peri-umbilical - Cullen sign
b. Flanks - Grey Turner sign
Any Visible masses
Tumor, hernia, pulsation
Finding
Association
Cullens sign
Retroperitoneal hemorrhage
(hemmorrhagic pancreatitis,
abdominal aortic aneurysm
rupture
Kehrs sign
Splenic rupture
Eptopic pregnancy rupture
McBurneys sign
Appendicitis
Murphys sign
Acute cholecystitis
Iliopsoas sign
Obturators sign
Grey-Turners sign
Chandelier sign
Rovsings sign
Appendicitis
Appendicitis
Retroperitoneal hemorrhage
(hemorrhagic pancreatitis,
abdominal aortic aneurysm
rupture)
Appendicitis
Palpation
see the expression of the patient and look for signs
of:
Tenderness (Tenderness)
Rebound (rebound tenderness)
Defans dystrophy (Muscle guarding / Rigidity)
Murphy's, Rovsing's signs
Period, lump (hole hernia, scrotum)
pulsation
Murphy's sign in
Acute Cholecystitis
Percusion
Tymphanitic
Dull
Shifting dullness
Auscultation
Bowel sounds (+/-)
Decreased / increased
Metallic sounds
Vascular bruit
Rectal Examination:
tenderness
induration
mass
frank blood
Vaginal Examination
- Bleeding
- Discharge
- Cervical motion tenderness
- Adnexal masses or tenderness
- Uterine Size or Contour
LABORATORY EXAMINATION :
- Complete blood count
- Urinalisis and pregnancy tests
- Blood chemistry
EXAMINATION OF RADIOLOGY :
- Chest x-ray
- Abdominal x-ray
3 positions: Upright, supine, lateral decubitus
Left
- ultrasonography
- CT-Scan
- MRI
Cholangitis
Pain at RUQ
Charcots triad (fever, pain RUQ, and jaundice),
Reynolds pentad, mild hepatomegaly, tachicardia.
Radiology : imaging (USG dan CT Scan)
Disease
Etiology
Characteristik Pain
Manifestation clinis
Acute
Biliary tract disease,
Pankreatitis alcohol, drugs, trauma,
hyperparathyroidism,
malnutrition,
hyperlipidemia, ductus
pankreas obstruction,
duodenum obstruction,
infection, ischemia,
herediter.
Nausea, vomit,
disensi abdomen,
fever.
Tenderness at
epigastrik, Bowel
sound (-) atau
decreased
Duodenal
ulcer
H. pylori, NSAID,
hipersecretion acid
Dyspepsia
H. pylori
Pain at epigastrik,
radiate to back in
lower scapula
Substernal pressure,
epigastric distress,
Nausea , flatulence
Lab
Radiologi
Hct ,
WBC
,
serum
amylase
treatment
Medication
surgery
Endoscopy
EKG
Disease
Etiology
Charateristic
Radiologi
Pengobatan
Plain
Appendectomy
pain
Appendisitis
Lumen
Obstruction
abdominal x-
cause fecalith,
radiate to right
, tenderness at mc
ray, USG,
parasite,
lower quadrant
burney point
CT- Scan
foreign body
abdoment
Pain at upper
nausea, vomit,
abdomen move
generalized
to right lower
lyphadenopathy,
quadrant
Temperature
abdoment
increased
Ectopic
Pain at right
Bleeding at vagina,
pregnancy
lowe abdomen
miss menstrual
bacteria
KET
Mild leukoctocis
Leukocytosis
surgery
Laparatomy
Urinalisis
Surgery
period
Ureterolithiasis
Pain radiate to
labia, scrotum,
penis
Hematuria
IVP
ALHAMDULILAH