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The Acute Surgical Abdomen Semiology

The document summarizes key subjective and objective clinical features that help diagnose an acute surgical abdomen. Pain is the most important subjective feature, with characteristics that can indicate conditions like perforation, obstruction, or pancreatitis. Vomiting, intestinal transit stoppage, and hiccups are other potential symptoms. Objective signs include fever, shock, respiratory issues, and specific inspection findings depending on the condition. Diagnostic tests like bloodwork, imaging, and procedures can further evaluate causes like bleeding, pancreatitis, bowel obstructions, or intra-abdominal injuries.

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Dona Teodor FC
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213 views9 pages

The Acute Surgical Abdomen Semiology

The document summarizes key subjective and objective clinical features that help diagnose an acute surgical abdomen. Pain is the most important subjective feature, with characteristics that can indicate conditions like perforation, obstruction, or pancreatitis. Vomiting, intestinal transit stoppage, and hiccups are other potential symptoms. Objective signs include fever, shock, respiratory issues, and specific inspection findings depending on the condition. Diagnostic tests like bloodwork, imaging, and procedures can further evaluate causes like bleeding, pancreatitis, bowel obstructions, or intra-abdominal injuries.

Uploaded by

Dona Teodor FC
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPT, PDF, TXT or read online on Scribd
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THE ACUTE SURGICAL

ABDOMEN SEMIOLOGY.
PARACLINICAL FINDINGS
I. SUBJECTIVE CLINICAL FEATURES

1. Pain the most important!


suddenly onset in a specific abdominal
territory
spreads all over
is joined by another clinical features
(abdominal tenderness, digestive reflex
phenomena)
Sudden onset brusc, extreme, like a knife stab
perforation
colic (obstruction)
acute pancreatitis (bar pain)
Pain headquarters
epigastric (in perforated GDU)
bar pain (AP)
per umbilical region (enter mesenteric infarct)
right iliac fosse (acute appendicitis)
right or left iliac fosse (ectopic pregnancy)
right hypochondria (acute colecistytis)
fixed localisation (torsion syndrome)
2. Vomiting

reflex manifestation
is present in almost all syndroms of ASA
initial alimentary
eventually bilious fecaloid
soon upper obstruction
time of onset
late lower obstruction
3. Stop of intestinal transit for stool and gases
mechanical obstacle (volvulus, tumor, invagination)
functional reflux peritonitis

4. Hiccup
reveals severe evolution of a peritoneal process.
II. GENERAL FEATURES

1. Fever
2. Shock reflex (due the pain)
- pallor
- cold sweat
- circulatory disorders
toxical-septic
- terous faccies
- dry tongue
eyes plugged in the eye socket
3. Respiratory disorders tachypneea
superficial breathing
III. Objective clinical manifestations

1. Inspection
peritontis terous facies
- dry skin
- immobile patient
- immobile abdomen towards
respiratory movements of the chest
intestinal obstruction protuberant abdomen
- intestinal peristaltics
are
sometimes visible
2. Percussion disappearance of flatteness in the
pre-hepatic area (in perforation)
3. Auscultation no peristaltic in evolutive
peritonitis
hydroaeric noiser hiperperistaltics

in occlusion
4. Digital rectal examination (DRE)
tumors
IDH
empty rectal ampul (i.o.)
foreign objects
tension of Douglas bottom bag
5. Digital vaginal examination (DVE)
organ torsion
ectopic pregnancy
IV. PARACLINICS
1. Ht. significant after 6-12h trow onset of bleeding
2. Amylase
3. WBC
4. RADIOLOGY
a. Native (no contrast substance)
- standing
- dorsal R / L decubitus
- pneumoperitoneum
- hydroaeric levels central (small bowel)
peripheric (organ
tube tipe in large
bowel
obstruction)
b. Rx pelvis
kidney
chest
c. Selective arteriography
d. Urography
e. Abdominal punction
f. Ultrasound
g. Diagnostic laparoscopy
h. CT
i. RMI

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