What is an "acute abdomen": symptoms and first aid
The totality of the symptoms that occur with certain diseases of the abdominal organs is classified in medicine as an acute abdomen.This condition is always completed by peritonitis( the inflammatory process of the membrane that lining the abdominal cavity, which requires immediate surgical care).Contents: Causes of acute abdominal symptoms of acute abdomen and first aid Psevdoabdominalny syndrome Projections for acute abdomen
Causes of acute abdomen
Considered condition can occur for many reasons, but doctors have identified a number of basic:
- inflammation of the appendix -acute appendicitis;
- inflammation of the gallbladder - acute cholecystitis;
- closed abdominal injuries, as a result of which internal organs are damaged;
- penetrating wounds of the abdominal wall with damage to the internal organs;
- inflammation of the pancreas - acute pancreatitis;
- inflammation of the ovaries and fallopian tubes in a woman - salpingo-oophoritis;
- perforation, which occurred due to the progression of peptic ulcer or tumor process;
- internal bleeding - for example, with a rupture of the fallopian tube in the background of an ectopic pregnancy;
- torsion of the ovarian cyst;
- thrombosis of mesenteric vessels;
- an obstruction of an intestine.
symptoms of acute abdomen and first aid
help make an accurate diagnosis of the following symptoms:
- intense pain in the abdomen;
- prolonged hiccough;
- bloating in the absence of gases;
- total absence of stool;
- modified feces.
Pain almost always appears suddenly and sharply and intensively in the condition under consideration - many patients describe this sensation as a "kick in the stomach".In rare cases, pain in the acute abdomen does not appear abruptly, it develops, its intensity increases gradually, often the pain becomes stronger when the patient tries to take a recumbent position.
Note: with internal bleeding pain will be completely absent, but in vomit masses and feces will be present blood - this is also the condition of the acute abdomen.
vomiting, lack of feces and flatulence are typical for advanced bowel obstruction, but in all other cases, these symptoms are either completely absent or have too low severity.
Once a patient with signs of acute abdomen gets to see a doctor, a specialist immediately carries out the following survey:
- Gather with family or the patient information on the symptoms duration, their severity, disease history.
- Attentively follow the behavior of the patient - a person can be too excited( to rush, scream from severe pain), which occurs most often with intestinal obstruction, or, conversely, apathetic, indifferent in peritonitis.
- When examining the tongue, two factors will be noted - its dryness and the presence of gray dense plaque.
- Pulse and palpitation in these patients are most frequent, but in rare cases these indicators will be reduced.
- If the doctor pays attention to the expressed pallor of the skin, lowering blood pressure and the appearance of cold sweat, then this will indicate the development of internal bleeding.
The doctor will definitely perform palpation of the abdomen - this is done very carefully, because even a slight pressure on the abdominal wall can provoke a powerful attack of pain. It is through palpation the doctor identifies syndromes of peritoneal irritation:
- muscular defense: abdominal muscles over its entire area or in certain areas heavily strained;
- symptom of Schetkina-Blumberg: when pressing on the abdomen and sharply discarding the hand, the patient will feel a sharp increase in the pain syndrome.
The most pronounced symptoms of irritated peritoneum are present in acute inflammation in the abdominal organs, perforation or damage.
The next stage of the survey is tapping of the abdominal wall( percussion), which will help to detect the disappearance of hepatic dullness.The fact is that the normal sound when tapping the lower right thorax is blunt and very different from the sound of the left half of the chest.In the event of air entering the abdominal cavity, the hepatic dullness disappears.
The doctor will perform a rectal examination of the patient - he needs to identify tumors, swollen bowel loops, or black gloves on the glove in the absence of natural feces.A similar rectal examination will be most informative for patients of childhood.In women, the vagina is being examined.
As a rule, the doctor will diagnose an acute abdomen only if acute pain is combined with irritated peritoneum syndrome, abdominal distention and / or abdominal wall tightening.The patient in this case immediately goes to a medical institution - the condition of the acute abdomen requires immediate surgical treatment.
A person who develops and develops signs of the condition in question should not use any painkillers, drugs with spasmolytic effect, hypnotics, and in general any medications.The fact is that taking medications can reduce the intensity of the characteristic symptoms, and this will make the diagnosis of the acute abdomen difficult.Especially dangerous is the use of laxative medicines - this can provoke the release of fecal matter into the abdominal cavity.
As soon as a patient with signs of an acute abdomen gets to a medical institution, he immediately makes a complete examination - X-ray, ultrasound and / or endoscopy.If the institution has the necessary laparoscopic instrument, then the abdominal examination is performed using a laparoscope, in many cases the surgical treatment is performed directly during the examination with the same laparoscope.
Often, the symptoms characteristic of an acute abdomen may indicate the development of other diseases - a pseudoabdominal syndrome develops, which does not allow specialists to conduct accurate diagnostics.
Causes for which a false sharp abdomen may occur:
- exacerbation of gastric ulcer and / or duodenal ulcer;
- myocardial infarction;
- intercostal neuralgia;
- enteritis and colitis;
- food poisoning;
- some gynecological pathologies;
- pneumonia and / or pleurisy;
- pyelonephritis and other pathologies of the kidney and urinary system;
- diabetes mellitus;
- progression of neoplasms in a benign or malignant organism.
To exclude all these diseases, the patient is placed in a hospital and is monitored.Usually, the intensity of the pain syndrome decreases sharply, the tension of the abdominal muscles becomes weak after a short time.
Treatment of pseudoabdominal syndrome is performed with the help of individually selected therapy, surgical intervention will not be required in most cases.
Forecasts for an acute abdomen
There is no single-valued prediction for the condition in question, as it depends on many factors:
- how quickly the patient was taken to a medical institution;
- how quickly the diagnosis was made and surgical treatment was performed;
- age of the patient;
- is available in a history of chronic disease.
If the patient did not take food, liquids, medicines and seeking professional medical help before the doctor arrived, the forecasts will be favorable.
Tsygankova Yana Aleksandrovna, medical reviewer, therapeutist of the highest qualification category