Case review
74-year-old Grandpa Zhang often felt abdominal pain these days, and he didn't come to the hospital until the pain was unbearable. It turned out that Grandpa Zhang had suffered from chronic appendicitis many years ago, and this time the severe abdominal pain was related to the recurrence of appendicitis.
Coincidentally, 86-year-old Grandma Liu recently developed abdominal pain, bloating and other symptoms, accompanied by violent vomiting, and after examination, Grandma Liu was diagnosed with intestinal obstruction.
In both cases, the two elderly patients had different diseases, but both fell into the category of acute abdomen. Acute abdomen is a type of disease characterized by sudden abdominal pain, and its symptoms are varied. Due to the deterioration of organs and functions, and the body's insensitive response to inflammation, the symptoms of acute abdomen in the elderly are often atypical, easy to be overlooked, and treatment is delayed.
Below, I will introduce you to the common symptoms of acute abdomen and what to do after an acute abdomen.
Take you through the acute abdomen
Acute abdomen is a general term for abdominal diseases with acute abdominal pain as the main clinical manifestation, characterized by acute onset, rapid progression, severe disease, and diverse manifestations. Common causes of acute abdomen include appendicitis, bile duct disease (cholecystitis/biliary stones), perforation of the digestive tract, intestinal obstruction, etc., which usually require urgent treatment.
Appendicitis Appendicitis Appendicitis is a common cause of acute abdomen, usually caused by an inflammatory response caused by obstruction of the lumen of the appendix, and patients may present with severe abdominal pain, fever, nausea, and vomiting.
Cholecystitis/Biliary Stones Cholecystitis is inflammation of the gallbladder, and biliary stones are cantons of stones in the gallbladder or bile ducts that impede bile excretion and cause abdominal pain. Patients may have severe pain in the right upper abdomen, nausea, vomiting, and other symptoms.
Gastrointestinal Perforation Perforation of the digestive tract can be caused by peptic ulcers, gastrointestinal tumors, or other lesions. When a perforation occurs in the digestive tract, digestive juices and food debris from the digestive tract leak into the abdominal cavity, causing severe peritonitis. This condition usually manifests as severe abdominal pain, tension in the abdominal muscles, etc.
Intestinal Obstruction Intestinal obstruction is when a part of the intestine is blocked, preventing food or liquid from passing through, causing abdominal pain, vomiting, constipation and other symptoms. Intestinal obstruction can be caused by intussusception, tumors, adhesions, inflammation, etc.
Gastrointestinal bleeding Gastrointestinal bleeding can be caused by ulcers, gastrointestinal tumors, esophageal varices, and other disorders, and patients may present with symptoms such as melena, hematemesis, and abdominal pain.
Peritonitis Peritonitis is inflammation of the peritoneum that can be caused by bacterial infection, chemical irritation, etc. Patients may present with severe abdominal pain, fever, and tension in the abdominal muscles.
How to distinguish an acute abdomen
An acute abdomen requires prompt intervention. Here's what you can tell if you have an acute abdomen.
Sudden Severity and Severity of Symptoms An acute abdomen usually occurs suddenly and is severe. Patients should be aware of sudden onset of severe abdominal pain, vomiting, abdominal distension, and persistent nausea.
Duration of pain Usually, the pain in an acute abdomen is constant and may worsen gradually. If symptoms persist for a long time or do not resolve for a short period of time, be alert to a possible acute abdomen.
Location of Pain and Radiating Pain Acute abdomen has different locations of pain in different situations, mainly related to the location of abdominal organ involvement, and sometimes pain can radiate to other areas, such as the back, shoulders, or lower back. If you feel pain in your abdomen and the pain radiates to other areas, you should be alarmed.
Nature and characteristics of pain The pain in an acute abdomen is usually a sharp, knife-like or stabbing pain rather than a dull or bloating pain. People may feel unusual tightness or stiffness in their abdomen rather than just discomfort.
Whether it is accompanied by other symptoms The pain of an acute abdomen is usually accompanied by other symptoms such as vomiting, diarrhea, constipation, fever, sweating, paleness, and rapid heartbeat.
Abdominal palpation Patients can gently press on the abdomen, noting signs such as abdominal tenderness and tension in abdominal muscles. If you have severe pain, severe tenderness or muscle tension in your abdomen, you may have a serious abdominal condition.
prompt
Patients should pay close attention to their symptoms and their changes, and be sure to seek medical attention if symptoms such as severe abdominal pain occur suddenly. When you seek medical attention, you should inform your doctor in detail about your symptoms and medical history, especially the history of acute abdomen and surgery, which can help doctors quickly identify the acute abdomen and take appropriate treatment measures.
What to do in case of acute abdomen
Seek medical attention as soon as possible Patients and their families can call the "120" emergency number immediately or go directly to the nearest hospital for medical help. The goal of seeking medical attention is to identify the cause of the disease early and take appropriate treatment measures immediately.
Stay quiet On the way to the hospital, patients should try to be quiet, avoid strenuous exercise, and breathe as smoothly as possible. Doing so can help reduce pain and discomfort in the abdomen and is important for first aid in acute abdomen.
Avoid eating and drinking, and patients may need surgery. Eating and drinking can increase peristalsis in the gastrointestinal tract and secretion of digestive juices, aggravate abdominal pain, and cause symptoms such as nausea and vomiting. Vomiting not only worsens abdominal discomfort, but can also lead to fluid and electrolyte imbalances, worsening the condition and increasing the risk of surgery. In addition, the presence of food and liquids may affect the accuracy of imaging tests and interfere with the doctor's examination and evaluation of the condition. For an acute abdomen due to intestinal obstruction, eating and drinking can increase intestinal pressure and increase the risk of obstruction or rupture, which can worsen the condition.
Loosening clothing If people feel difficulty breathing or a sense of urgency, they can be loosened to relieve pressure and discomfort in the chest and abdomen.
Don't take pain relievers Pain relievers can mask symptoms and interfere with your doctor's diagnosis of the disease. Patients should avoid self-administering pain medication without a doctor's evaluation.
Observe Patients and their families should pay close attention to changes in symptoms and describe symptoms as accurately as possible at presentation. If the patient has other chronic diseases, it is recommended to bring past medical records to the doctor to help the doctor make a correct diagnosis and treatment.
Family members should provide emotional support to the patient Acute abdomen may cause psychological stress and anxiety. At this time, family members need to comfort the patient appropriately and give him adequate emotional support, so that the patient can calmly face his or her condition and follow-up treatment.
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By taking a medical history, observing the nature and location of pain, evaluating accompanying symptoms, and performing palpation and imaging tests, doctors can quickly identify an acute abdomen and take appropriate treatment measures.
Source: Elderly Health News
Text: Zhang Huizi, Emergency Department, Huaibei Miners General Hospital
Curator: Zheng Yingfan
Editor: Wang Qianhui and Qin Mingrui
Proofreader: Li Shiyao
Review: Guan Zhongyao, Xu Bingnan