What is the significance of bowel sounds? Bowel sounds are notoriously inaccurate in the surgical evaluation of the abdomen. Their absence may be indicative of ileus or peritonitis, whereas loud borborygmi, tinkling, or rushes may be suggestive of an obstructive process.
Is acute abdomen ruled out by absence of fever or leukocytosis? No. Fever and leukocytosis are often late occurrences. Older and immunocompromised patients may be unable to mount an immune response even late in the course of the disease process.
What is meant by the term “referred pain”? Referred pain is a phenomenon whereby pain is felt at a location other than the site of painful stimulus. Classic examples are pain in the left arm or jaw with a myocardial infarction, or pain at the tip of the scapula with liver or gallbladder pathologic conditions. …
What is the nature of intestinal pain? The intestines themselves are insensate to direct pain from traumatic injury or inflammation. However, intense pain can be elicited from stretching or distention, as well as contraction against resistance, as is seen in colicky pain from obstruction.
What is the significance of rebound pain, and should it be elicited? If one palpates deeply with the fingers and suddenly releases the manual pressure, often this may elicit severe pain on the rebound in patients with peritoneal irritation. Many surgeons believe that this sign does not convey any more information than can be obtained …
Innervation of the peritoneum. What are peritoneal signs? The peritoneum is derived from the mesoderm. It consists of two double-layered sheets of cells that form the visceral and parietal layers, each with their own sensory innervation. The visceral layer covers the organs and has autonomic innervation. These slow C fibers can respond to various stimuli …
What is meant by the term acute abdomen ? The classic definition refers to the sudden onset of severe abdominal pain of unclear cause. Acute abdomen refers to any abdominal condition that requires prompt diagnosis. Often acute abdomen is equated with inflammation of the peritoneum or peritonitis, but they are not identical. Although many cases may ultimately require …