Acute abdomen topics for General Physicians
How acute abdomen is tested
Written for DHA, SMLE, DOH, QCHP, OMSB, MOH, NHRA and Kuwait MOH — the same GP licensing mix, not a acute abdomen specialist paper.
Acute abdomen items test surgical vs medical, when CT delays theatre, and the classic appendicitis/perforation splits.
A peritonitic, shocked patient belongs in theatre, not in the scanner. Appendicitis is clinical plus ultrasound/CT by body habitus and pregnancy.
Mesenteric ischaemia is pain out of proportion plus lactate and AF. Know when to call vascular/surgery rather than giving another PPI.
Who should not wait for CT?
Generalised peritonitis, unstable bleeding, or obvious perforation with free air and shock. Imaging is for the equivocal stable patient.
Pregnant abdominal pain — first imaging?
Ultrasound first. MRI when needed. CT is not the opening move unless life-threatening and no alternative.
What appendicitis pitfall do they write?
Retrocaecal and pelvic presentations, and that antibiotics do not replace surgery when perforation and peritonitis are already there.
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