Surgical emergencies: acute abdominal pain (Part 2)
Adam Jones, Kevin Turner, and Ashok Handa continue to explain the treatment of patients in acute pain
- By: Kevin Turner, Adam Jones, Ashok Handa
In last month's article we explained how to deal with a call from an accident and emergency department to see a patient with severe undiagnosed acute abdominal pain. This month we consider three specific surgical abdominal emergencies: ruptured abdominal aortic aneurysm, perforated viscus, and pancreatitis.
Abdominal aortic aneurysms are important because they are common. About 1% of all men over 65 years have an abdominal aortic aneurysm, and if this ruptures mortality is over 50% - and that is only in the people who survive long enough to reach hospital.1
This diagnosis must not be missed because minutes matter. So when you see a patient in accident and emergency with abdominal pain who looks terrible, specifically try to exclude this diagnosis. Is the patient elderly? Is s/he known to have an abdominal aortic aneurysm? Is the pain radiating to the back and of sudden onset? The diagnosis is confirmed if