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Acute abdominal pain

Acute abdominal pain. epidemiology. Number one reason to visit an ED In 2006, 6.7% of ED visits — 8.04 million patient encounters . pathophys. Visceral pain: stretching of unmyelinated fibers that innervate the walls or capsules of organs “crampy, dull, achy”

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Acute abdominal pain

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  1. Acute abdominal pain

  2. epidemiology • Number one reason to visit an ED • In 2006, 6.7% of ED visits — 8.04 million patient encounters

  3. pathophys • Visceral pain: stretching of unmyelinated fibers that innervate the walls or capsules of organs • “crampy, dull, achy” • Organs are bilaterally innervated, so pain is perceived in the midline (appendix)

  4. Parietal pain: irritation of myelinated fibers that innervate the parietal peritoneum • Can be localized • Guarding and rebound • Will prefer to not move.

  5. Clinical features • Is the patient clinically ill? • Vitals, appearance, age • History • Physical exam • Auscultation • Palpation • Labs • imaging

  6. treatment • Analgesics • Anti-emetics • antibiotics

  7. Specials populations • Women • Ectopic pregnancy • PID • Elderly • Underreport symptoms What is the most common surgical entity in elderly patients with abdominal pain?

  8. Post of population • Ileus and early SBO • C. diff

  9. reference • Tintinalli, ch. 74

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