surgery_umbilical and hypogastrium pain
TRANSCRIPT
ACUTE ABDOMINAL PAIN AT
UMBILICAL & HYPOGASTRIC REGION
By: Siti Nurulismah Bt Che Haron
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Transtubercular planeSubcostal plane
Midinguinal points
Midclavicular plane
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Umbilical region: SI Cecum Retroperitoneal organs Abdominal aorta
Hypogastric region: Urinary bladder Uterus Transverse colon
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Umbilical region: Acute SI obstruction Acute intestinal ischemia Ruptured abdominal aortic aneurysm Acute Crohn's disease and ulcerative colitis Acute cystitis
Hypogastric region: Acute cystitis Acute urinary retention Acute dysmenorrhea Acute salpingitis
IS ALWAYS MOVING
MOST OF ABDOMINAL CONTENTS
Acute SI obstruction Acute intestinal ischemia Ruptured abdominal aortic aneurysm Acute Crohn's disease and ulcerative colitis Acute cystitis
UMBILICAL REGION
Acute SI ObstructionAbdominal pain is:• The 1st symptom and sudden onset• *Colicky• Usually severe• Associated with vomiting and
distention• Pain more predominant with LSIO
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*Acute Intestinal IschemiaAbdominal pain is:• Sudden onset• Severe • Colicky/continuous• Associated with peritonitis and
shock
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Gangrenous bowel*sequence after ischemia
Acute C’s D & UC
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Ac Crohn’s disease
Ac Ulcerative colitis
*Ileocecal Rectum - blood stained/purulent rectal discharge
Diarrhea Bloody mucoid diarrhea
Abdominal pain resemble acute appendicitis
*Abdominal pain - is late symptom and persistent
*Ruptured AAAAbdominal pain is:• Sudden onset, pulsating and severe• Also being felt at *back, thigh and groinSigns:• Hypotensive• Distended and visible large central
pulsating mass• *Marked guarding, tender and pulsatile
mass• Diminish bowel sound and present of
vascular bruits
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Abdominal aortic aneurysm*exhibiting significant distension of the aortic wall
Rupture of aortic aneurysm
Acute Cystitis
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Acute cystitis Acute urinary retention Acute dysmenorrhea Acute salpingitis
HYPOGASTRIC REGION
*Acute CystitisAbdominal pain is:• Sudden onset but mild• Associated with frequency, urgency,
dysuria, cloudy offensive urineSign: • Tenderness over urinary bladder
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Acute Urinary RetentionAbdominal pain is:• Sudden onset• Severe pain• Associated with anuriaSigns:• Visible, palpable and tender urinary
bladder
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An enlarged urinary bladder
*Acute DysmenorrheaAbdominal pain is:• Sudden onset• Range from mild to severe• Cramping• Start at the onset of menstrual flow
and lasts 8 – 27 hours
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Acute SalpingitisAbdominal pain is:• Gradual onset, constant and severe• *Precede/radiated by pain at lower part
of back• Associated with (precede by) yellow
white vaginal discharge, dysmenorrhea and burning pain on micturition
Signs: • Tenderness and guarding bilaterally
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Salpingitis*one of PID
Management
Investigation & Treatment
REFERENCES:
Bailey and Love’s Short Practice of Surgery 25th edition 2008 by Norman S. William, Christopher J.K. Bulstrode and P. Ronan O’connell
Browse’s Introduction to The Symptom and Sign of Surgical disease 4th edition 2005 by Norman L. Browse, John Black, Kevin G. Burnand
and William E.G. Thomas
Oxford Handbook of Clinical Surgery 3rd edition 2007 by Grey McLatchie, Neil Borley and Joanna Chickwe
Some of