1. Coffs Harbour Divisional Training
Abdominal Pain
9 November 2018
Coffs Harbour Divisional Training

2. Coffs Harbour Divisional Training
What is Abdominal Pain?
The term abdominal pain generally is used to describe pain originating from organs within the abdominal cavity.
9 November 2018
Coffs Harbour Divisional Training

3. Coffs Harbour Divisional Training
What is Abdominal Pain?
Organs of the abdomen include the stomach, small intestine, colon, liver, gallbladder, spleen, and pancreas
9 November 2018
Coffs Harbour Divisional Training

4. Coffs Harbour Divisional Training
What is Abdominal Pain?
Having said that, it is possible that pain may be felt in the abdomen even though it is coming from organs that are not within the abdominal cavity.
For example, conditions of the lower lungs, the kidneys, and the uterus or ovaries can also cause abdominal pain.
9 November 2018
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What is Abdominal Pain?
It also is possible for pain from organs within the abdomen to be felt outside of the abdomen.
For example, the pain of pancreatic inflammation may be felt in the back.
9 November 2018
Coffs Harbour Divisional Training

6. Coffs Harbour Divisional Training
What is Abdominal Pain?
These types of pain are often called "referred" pain.
The pain does not originate in the location that it is felt.
9 November 2018
Coffs Harbour Divisional Training

7. Coffs Harbour Divisional Training
Appendicitis
9 November 2018
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8. Coffs Harbour Divisional Training
Appendicitis
The appendix is a small, worm-like appendage attached to the colon.
9 November 2018
Coffs Harbour Divisional Training

9. Coffs Harbour Divisional Training
Appendicitis
9 November 2018
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10. Coffs Harbour Divisional Training
Appendicitis
Appendicitis occurs when bacteria invade and infect the wall of the appendix.
9 November 2018
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11. Coffs Harbour Divisional Training
Signs and symptoms
This pain is at first not confined to one spot (circular motion of their hand).
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12. Coffs Harbour Divisional Training
Signs and symptoms
Loss of appetite
Nausea and vomiting
Fever
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13. Coffs Harbour Divisional Training
Signs and symptoms
Abdominal tenderness
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14. Coffs Harbour Divisional Training
Signs and symptoms
As the inflammation increases, the pain changes and can be localised clearly to one small area.
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Signs and symptoms
Generally, this area is between the front of the right hip bone and the belly button (McBurney's point).
9 November 2018
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16. Coffs Harbour Divisional Training
Signs and symptoms
It is worth mentioning that even experienced ER specialists often find it difficult to diagnose appendicitis accurately.
9 November 2018
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17. Coffs Harbour Divisional Training
Signs and symptoms
By applying hand pressure to a patient's abdomen (McBurney's point) and then letting go, a sharp pain is often felt upon the release of the pressure. This is called rebound tenderness.
9 November 2018
Coffs Harbour Divisional Training

18. Coffs Harbour Divisional Training
Signs and symptoms
Basically, the lining of the abdominal cavity (peritoneum) has been irritated by stretching or moving.
Rebound tenderness is often a clinical sign associated with appendicitis particularly at McBurney's point.
9 November 2018
Coffs Harbour Divisional Training

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Complication
The most frequent complication of appendicitis is perforation.
This can lead to a collection of infected pus or peritonitis (infection of the entire lining of the abdomen and the pelvis).
9 November 2018
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Complication
The major reason for perforation is delay in diagnosis and treatment.
In general, the longer the delay between diagnosis and surgery, the more likely it will occur.
9 November 2018
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Complication
Another less common complication is sepsis.
A condition in which infecting bacteria enter the blood and travel to other parts of the body.
This is a very serious, even life-threatening complication.
9 November 2018
Coffs Harbour Divisional Training

22. Coffs Harbour Divisional Training
Gallstones
9 November 2018
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23. Coffs Harbour Divisional Training
Gallstones
Gallstones are "stones" that form in the gallbladder or bile ducts.
9 November 2018
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24. Coffs Harbour Divisional Training
Gallstones
Generally, they are formed when bile, which is produced in the liver and stored in the gallbladder, looses so much water and becomes very concentrated that it super saturates.
Crystals are then formed.
9 November 2018
Coffs Harbour Divisional Training

25. Coffs Harbour Divisional Training
Gallstones
The common types of gallstones are cholesterol, black pigment, and brown pigment.
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Gallstones
Gallstones may be as small as a grain of sand or as large as a golf ball.
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Gallstones
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Gallstones
Often medical treatment may not be necessary unless the gallstones present symptoms
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Signs and symptoms
Biliary colic is a very specific type of pain, occurring as the primary or only symptom in 80% of people with gallstones who present with symptoms.
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Signs and symptoms
The pain generally increases quickly and may last from a few minutes to several hours before subsiding.
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Signs and symptoms
It may be moderate to severe and may be felt in the upper right section or centre of the abdomen.
9 November 2018
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32. Coffs Harbour Divisional Training
Signs and symptoms
However, the pain can also run through to the back, between the shoulder blades or into the right shoulder.
9 November 2018
Coffs Harbour Divisional Training

33. Emergency signs and symptoms
Fever, sweating and chills
Steady, severe abdominal pain that persists for longer than a few hours
Abdominal pain that is so intense they can’t sit still
Jaundice — a yellowing of the skin or whites of the eyes.
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34. Coffs Harbour Divisional Training
Cholecystitis
9 November 2018
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Cholecystitis
Cholecystitis is the medical word used to describe inflammation of the gallbladder
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Cholecystitis
There may be no stone involved (acalculus).
Sometimes a semi-solid stone still in formation called sludge is the culprit.
9 November 2018
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Signs and symptoms
Cholecystitis usually presents as pain high up in the abdomen, above the belly button, or to the right upper abdomen.
9 November 2018
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Signs and symptoms
The pain is usually continuous and may spread to the right side of the chest and over to the back.
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39. Coffs Harbour Divisional Training
Diverticulitis
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Diverticulitis
Diverticulitis is a common digestive disease particularly found in the large intestine.
9 November 2018
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41. Coffs Harbour Divisional Training
Diverticulitis
Basically, it involves the formation of pouches (diverticula) on the outside of the colon.
Diverticulitis results if one or several of these pouches becoming inflamed.
9 November 2018
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42. Coffs Harbour Divisional Training
Diverticulitis
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Signs and symptoms
Patients often present with abdominal pain in the left lower quadrant.
9 November 2018
Coffs Harbour Divisional Training

44. Coffs Harbour Divisional Training
Signs and symptoms
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45. Coffs Harbour Divisional Training
Signs and symptoms
Fever
Nausea
Diarrhea or constipation
Cramping
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46. Coffs Harbour Divisional Training
Signs and symptoms
There is also an elevation of the white cell count in blood tests (Leukocytosis).
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Coffs Harbour Divisional Training

47. Coffs Harbour Divisional Training
Questions
9 November 2018
Coffs Harbour Divisional Training