Acute Abdomen in the ICU Patient

Posted by e-Medical PPT
Acute abdominal pathology that if left untreated will increase patient MORBIDITY & MORTALITY

Visceral and parietal peritoneum
Peritoneal fluid normally <50ml
Absorbed via lymphatics in omentum and diaphragmatic peritoneum (30%)
Omentum acts as physiologic “patch” for perforation or infection
Pain – somatic and visceral
Somatic from direct irritation of parietal peritoneum, visceral follows embryologic origin or major splanchnic vessels
Refered pain – ex. Shoulder and phrenic nerve
Similar incidence of common diseases as general population plus more unique processes
Post-surgical state
Hypotension and low flow states
Antibiotic therapy (Overgrowth ex. C. diff)
Poor nutrition

Postoperative Considerations
Anastamotic leak
Fascial Dehiscence
Bowel obstruction
Abdominal Compartment Syndrome

Bowel obstruction
Diagnosis often confounded by normal post-op adynamic illeus
Patients on narcotic pain meds
Management per standard protocol
Complete obstruction or nonresolving/ worsening PSBO requires reoperation..

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