In this episode the always excellent Dr Charlotte Peal guided us through the often dramatic world of Upper GI bleeds.
Following on from the Acute Abdomen podcast Mr Riad Hosein goes through some hypothetical cases of patients with abdominal pain. This episode puts into practice the principles discussed in the Acute Abdomen podcast.
Mr Riad Hosein came down to discuss the Acute Abdomen and how to approach a patient with abdominal pain. Red flags are discussed as well as how to differentiate the patient with a life threatening acute abdomen.
Some key points from the podcast:
- 40% will have a final diagnosis of non-specific abdominal pain
- 20% appendicitis
- 20% gallstone disease
- 20% other causes
(Patterson-Brown, S., The acute abdomen, in Principles and Practice of Surgery, e.a. OJ Garden, Editor. 2007, Churchill Livingstone: Edinburgh. p. 332-340, King KE, W.J., Abdominal Pain, in Rosens Emergency Medicine: Concepts and Clinical Practice, H.R. Marx JA, Walls RM, Editor. 2006, Mosby: Alibani. p. 1343-54).
Cochrane review stated that there is no evidence that opiates mask the signs of peritonism or lead to a delay in diagnosis (Lameris, W., et al., Imaging strategies for detection of urgent conditions in patients with acute abdominal pain: diagnostic accuracy study. BMJ, 2009. 338(jun26_2): p. b2431-).
Here's the RCEM page on Abdominal Pain without shock