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Acute abdominal disease s

Semmelweis University, Faculty of Medicine , 1 st Department of Surgery. Acute abdominal disease s. István PULAY M.D. Acute abdominal catastrophe. Diffuse peritonitis, ileus, intraabdominal bleeding, abdominal trauma, intraabdominal thrombosis, embolisation Mortality rate Year 1900. 100%

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Acute abdominal disease s

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  1. Semmelweis University, Faculty of Medicine, 1st Department of Surgery Acute abdominal diseases István PULAY M.D.

  2. Acute abdominal catastrophe • Diffuse peritonitis, ileus, intraabdominal bleeding, abdominal trauma, intraabdominal thrombosis, embolisation • Mortality rate • Year 1900. 100% • Year 2000. 10-20%

  3. Acute abdominal diseases • Secondary peritonitis • Ileus – strangulation • Intra-abdominal bleeding • Intraabdominal • Thrombosis • Embolisation • Abdominal trauma

  4. Acute abdominal pain • Acute abdominal pain existing more than 6 hours have to think on acute abdominal disease

  5. Types of Abdominal Pain Visceral • It occurs early and poorly localized Parietal • It occurs later and better localized. • Referred Pain is usually felt in the region of involved organ

  6. Non specific abdominal pain • In 40% of all admitted patient into hospital has non specific pain • It is not possible to discover the reason of pain

  7. Peritonitis • Inflammatory process of peritoneal cavity, doe to pathophysiology causes fluid loss and develope multiorgan failure rapidly • The final outcome without therapy is death

  8. Types of peritonitis • Primary • Develops in ascitic fluid of cirrhotic patients • Secondary • Other pathophysiological process is in the background • Tertiery • Pathogens with low pathogenicity are the causative organisms

  9. Diagnosis • Physical examination • Inspection • Auscultation • Palpation • Plain abdominal X ray • Laboratory findings • Ultrasound • CT • Laparoscopy

  10. Differential diagnostic problems • Cardiopulmonary (AMI) • Abdominal wall (hernia, zooster) • Toxic-metabolic (diabetes, overdose. lead ) • Neurogenic (zooster, lues) • Psychic ( anxiety, depression) • Nonspecific pain

  11. Pathophysiology • Colonisation • Infection • MODS • SIRS • Sepsis • Septic shock

  12. Therapy of secondary peritonitis • Maximum supply • Duodenal tube • Adequat antibiotic therapy • Surgical intervention • Stop of source • Cleansing • Drain

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