Summary

In study session II you have learnt

• The term acute abdomen denotes any sudden condition with chief manifestation of pain of recent onset in the abdominal area which may require urgent surgical intervention.
• Intestinal obstruction is a partial or complete blockage of the intestine that keeps food or liquid from passing through from small intestine or large intestine and producing symptoms of vomiting, constipation, distension and abdominal pain.
• Obstruction leads to proximal dilatation of the bowel and disrupts peristalsis. Bowel above the obstruction becomes distended with fluid and gas. This stimulates excessive peristalsis producing colicky pain. As distension increases with time, blood vessels in the bowel will be stretched and narrowed impairing blood flow and leading to ischemia.
• The sigmoid colon is the most frequent site of volvulus in the large bowel.
• Appendicitis is an acute inflammation of the vermiform appendix, a narrow, blind tube that extends from the inferior part of the cecum. Subsequently, a patchy necrosis, gangrene and perforation develop resulting in peritonitis and sepsis and finally death. An appendectomy is the preferred method of management for acute appendicitis if the inflammation is localized.
• Peritonitis is the inflammation of the peritoneal cavity. It is an acute life-threatening condition caused by bacteria or chemical contamination of the peritoneal cavity. Resuscitation: general patient care with intravenous fluids
• General management of acute surgical abdomen includes decompression of the stomach by nasogastric tube, fluids resuscitation to restore the circulatory state, laparatomy and managing other problems such as infection and cardiovascular problems.
• Anesthetic management includes volume resuscitation, oxygen, monitoring urine output, rapid sequence induction, awake extubation, maintain temperature and proper analgesia
• Initial resuscitation for intestinal obstruction is crystalloid solutions but peritonitis should be with colloid or blood depending on the hemoglobin.