Acute Abdomen

Acute Abdomen

1. Definition

   • Sudden, severe abdominal pain

2. Causes

   • Acute appendicitis
   • Acute peptic ulcer and its complications
   • Acute intestinal ischemia
   • Acute cholecystitis
   • Ovarian torsion
   • Acute peritonitis
   • Abdominal aortic aneurysm
   • Kidney Stones
   • Pancritits

3. Also caused by

   • Acute pancreatitis
     • Pancreatic Secretory function
       • Exocrine
         • Stimulated by chyme in the upper part of the small intestine
           • Digestive enzymes for protein, carbohydrates and fats
             • Acini
           • Aqueous component bicarbonates ions and water
             • Epithelial cells of the ducts
       • Endocrine
         • Secretion of hormones directly into the blood
     • causes
       • Alcoholism
       • Gall stones
       • Medications (thiazides)
       • Hypertriglyceridemia
       • hypercalcemia
       • Infections: mumps, coxackie, CMV
       • Genes: PRSS1, SPINK1
     • Pathophysiology
     • Sign & symptoms
       • Upper abdominal pain
         • Fever
           • Rapid pulse
             • Nausea & vomiting
               • Tenderness when touching the abdomen
     • complications
       • SIRS
         • Pseudocyst
           • Infected pancreatic necrosis
             • Adenocarcinoma
               • DIC + ARDS
     • Lab investigations
       • Serum amylase
         • Serum lipase & SIT
           • Decreased fecal elastase
             • Neutrophilic leukocytosis
     • Other investigations
       • MRI
       • ERCP
     • Management
       • nutritional support
         • fluid resuscitation
           • pain control
             • Surgery

4. Anatomy of the pancreas

5. Histology of the pancreas

6. innervation od the abdomen

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