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Acute abdomen

Bleeding into the abdomen accompanied by pain in the abdomen, sometimes giving in one or another shoulder. There are signs of blood loss: the skin and the mucous membrane pale lips turn white, nose, ears, limbs cold, face and forearms covered in a cold sweat. The patient complains of thirst, lack of air, noise in the ears, dizziness, possible fainting; the pulse is weak - 110-120 strikes in 1 min and more. Blood pressure is reduced, the body temperature is normal. Belly painful, slightly tense and slightly swollen. There is often a symptom of peritoneal irritation. If percussion is determined dullness in the lateral parts of the belly. Women guidance for the delay of menstruation, bleeding from the vagina, the presence of these symptoms should imply the break prodovolstvia for ectopic pregnancy. If these symptoms developed after abdominal traumas, you can think of rupture of the spleen, liver or damage mesenteric vessels. Not in all cases when bleeding in the abdomen signs are immediately pronounced; sometimes they are detected with some delay. Supervision over the General condition of the patient, pulse, blood pressure and hemoglobin (the rapid development of anemia) always allows me to recognize life-threatening bleeding in the abdomen.
Rich gastrointestinal bleeding are not accompanied by symptoms of acute abdomen, but when they may occur with a grave danger to the patient and the need for an urgent operation. They are bloody vomit or bloody stools. With significant blood loss observed above signs of severe anemia. Vomit can be kind of dark blood to clot or coffee grounds. Changes from the stomach may be very poor or may not have them.
Acute intestinal obstruction (see) is accompanied with sharp pain in the stomach, delayed chair and gases, hiccups, vomiting. The pain appears suddenly, is cramping character: increases, reaches a high degree and in 1-2 minutes weakened, and after some time it occurs again. There is often vomiting, again, obstinate, sometimes intestinal contents. Stomach or evenly swollen, visible or separate bloated loop guts. Bloating is usually not accompanied by the muscles of the abdominal wall. Often visible reinforced peristalsis of intestines. Percussion stomach in case of obstruction of the large intestine is determined by a uniform timpani, when obstruction of the small intestine sites serving may alternate with areas of very high campanita. Listening to the abdomen with a mechanical obstruction in the first hours identifies rapid intestinal peristalsis. The impetus for the anterior abdominal wall overflow small intestines causes the sound of lapping.
In advanced cases it is difficult to distinguish different forms of acute abdomen was now available diffuse peritonitis and paralytic ileus. General condition of the patient is deteriorating due to intoxication and collapse (see).
In children and the elderly symptoms of acute abdomen is often atypical. Inflammatory diseases in children occur heavier due to the weak development of greater omentum. Plastic properties of the peritoneum in children is also very weak, so they are not happening fast separation processes in the abdominal cavity. Acute appendicitis is often toxic nature with a sharp disorders of the cardiovascular system (see Appendicitis in children).