Other GI Condition

exp date isn't null, but text field is

ACUTE ABDOMEN

  • This refers to sudden, severe abdominal pain.
  • It is in many cases a medical emergency, requiring urgent and specific diagnosis.
  • Several causes need immediate surgical treatment

 

PERITONITIS

  • Refers to inflammation of the peritoneum.
  • Possible Causes: appendicitis, pancreatitis, acute cholecystitis, bowel obstruction or perforated peptic ulcer.

Clinical Features

SIGNS AND SYMPTOMS

  • Rebound tenderness, guarding, rigidity of the abdominal wall. The patients may also present in septic shock if there is a bowel perforation, appendiceal rupture or cholangitis.

INVESTIGATIONS

  • Full blood count
  • Group and save
  • Amylase and lipase (if pancreatitis suspected)
  • Abdominal x-ray (supine and erect) if obstructive causes suspected
  • Abdominal ultrasound – if pancreatitis, appendicitis, cholecystitis suspected

Treatment 

  • Intravenous fluids, analgesia, NPO and insert nasogastric tube
  • IV antibiotics: Only indicated for appendicitis, cholecystitis and bowel obstruction with perforation.
  • Do not prescribe antibiotics for pancreatitis or bowel obstruction without perforation.
  • IV Ceftriaxone 2g 24 hourly for 5-7 days
  • IV Metronidazole 500mg 8 hourly for 5–7 days

Surgery:

  • Indicated in all patients with peritonitis, large bowel obstruction, adhesions and small bowel obstruction after failed conservative management, appendicitis (with or without rupture) and perforated peptic ulcers.
  • Indicated for all bowel obstruction due to adhesions or other causes if full blood count shows a leucocytosis.

REFERRAL: 

  • if there is no expertise available.
  • If the patient is operated and develops complications and requires ICU or re–operation.
  • For cholecystitis if no improvement after course of antibiotics.