Gastrointestinal/urological/gynecologic emergencies

Acute abdomen

• Sudden onset abdominal pain

• Usually indicates peritonitis

Cholecystitis

• Inflammation of gallbladder

• Pain in URQ, referred pain in right shoulder

Diverticulitis

• Inflammation in small pockets at weak areas in muscle walls of the intestines

• Pain in LLQ

• Scar tissue can cause constipation and bowel obstruction

  • Can lead to perforation→ peritonitis, severe infection, septic shock

Cystitis

• Inflammation of the bladder

• Pain in lower mid-abdomen (retropubic)

Emesis

Vomiting

Hematemesis

Vomiting blood

Hernia

Protrusion of an organ or tissue through an abnormal body opening

ileus

• Paralysis of the bowel

• Stops contractions that move material through intestine

Kidney stones

• Solid crystalline masses

• Form from excess of insoluble salts or uric acid crystallizing in the urine

Melina

Black, foul smelling, tarry stool containing digested blood

Pancreatitis

• Inflammation of pancreas

• Pain in upper abdomen (both quadrants), back

Peritonitis

• Inflammation of peritoneum

• Pain is diffuse

Strangulation

Complete obstruction of blood circulation in a given organ as a result of compression or entrapment

Appendicitis

• Direct pain in RLQ

• Referred pain around navel

• Rebound tenderness

Ulcer

• Upper midabdomen or upper part of back

Abdominal aortic aneurysm

• Pain in lower part of back and lower quadrants

Amylase

Produced by pancreas, breaks down starches into sugar

Bicarbonate

Neutralizes stomach acid into the duodenum

Esophageal varies

• Pressure within blood vessels surrounding esophagus increases

  • Frequently as a result of liver disease

• Eventually drain their blood into the liver

• If liver is damaged (ie alcoholism) and blood can’t flow through it easily, blood backs up in portal vessels

  • Dilates the vessels and causes leaking into the esophagus

• If pressure continues to increase, vessel walls may fail, causing massive upper GI bleeding

  • Symptoms: hematemesis, Melina, sudden onset discomfort in epigastric/sternal region, severe difficulty swallowing, signs of shock

  • Signs of liver failure: jaundice, weight loss, edema in abdomen, nausea and vomiting

Mallory-Weiss Tear

• Tear in the junction between the esophagus and the stomach

• Severe bleeding and eventually death

• Usually caused by violent coughing or vomiting

Gastroenteritis

Infection causing diarrhea, nausea, vomiting

Uremia

Kidneys fail → patient loses ability to excrete waste from body → waste product, urea, remains in blood → uremia

What is acute kidney injury and what might cause it?

Sudden decrease in function

• Hemorrhage

• Trauma

• Shock

• Dehydration

• Sepsis

• Heart failure

• Meds

• Drugs

• Kidney stones

What is chronic kidney disease often caused by?

Symptoms/complications of it (either untreated or missed a dialysis appt)?

• Diabetes or hypertension

• Symptoms:

  • Lethargy

  • Nausea

  • Headaches

  • Cramps

  • Edema in extremities and face

  • Heart disease

  • Bleed easily

• Complications:

  • Increased risk of heart failure and cardiac arrest

What might indicate a serious hernia problem?

• Reducible mass no longer reducible

• Pain at hernia site

• Red or blue skin discoloration over hernia

What is one risk of peritoneal dialysis and what symptoms might you see?

• Peritonitis

• Abdominal pain, hypotension, fever, nausea, diarrhea, cloudy dialysis fluid

Cervical polyps

• Polyps that grow on outside of cervix

• Causes:

  • Chronic inflammation of cervix.

  • Sexually transmitted infections (STIs), yeast infections or bacterial infections

• Symptoms:

  • Heavy menstrual periods (menorrhagia).

  • Bleeding after sex.

  • Abnormal vaginal bleeding, like between periods or after menopause.

  • Foul-smelling or pus-like white or yellow vaginal discharge.

Bacterial vaginosis

• Overgrowth of bacteria in the vagina

• Itching, burning, pain, fishy smelling discharge

Pelvic inflammatory disease

• Infection of fallopian tubes and surrounding tissue of the pelvis

• Abnormal/foul-smelling discharge, increased pain during sex, fever, malaise, nausea/vomiting

Chlamydia

Lower abdo pain, low back pain, nausea, fever, pain during intercourse, bleeding between menstrual periods

Gonorrhea

Painful urination, burning/itching, yellowish/bloody discharge, foul odor, blood during sex, cramping, abdo pain, nausea/vomiting, bleeding between periods