Pediatric emergency medicine trisk 2963 2963
Bạn đang xem bản rút gọn của tài liệu. Xem và tải ngay bản đầy đủ của tài liệu tại đây (43.75 KB, 1 trang )
hemorrhage
Gastrointestinal
perforation
Aneurysm with
rupture (intraabdominal)
Central nervous
system lesions
vomiting;
melena,
hematemesis, or
hematochezia;
shock;
tenderness and
guarding of
abdomen; bowel
sounds absent
Sudden abdominal
pain; shock;
guarding,
tenderness, and
rigidity of
abdomen; absent
bowel sounds
Abdominal pain
(chronic) with
acute
exacerbation
Palpable mass
Sudden onset of
shock
Convulsions;
gradual onset of
loss of
consciousness;
hemiparesis
abdomen
Peritoneal
aspiration
Endoscopy
Celiac arteriogram
bleeding vessel
during angiography;
surgical ligation
Plain radiograph
abdomen
(upright)
Treat shock
Surgical repair
Ultrasound
Celiac arteriogram
Treat shock
Surgical repair
Exclude
hypertensive
encephalopathy
CT scan, MRI
Carotid
arteriography
Supportive care
Control BP
Anticonvulsants
High-dose
corticosteroids
and/or
immunosuppressives
BUN, blood urea nitrogen; BP, blood pressure; IVP, intravenous pyelogram; EKG, electrocardiogram; CT, computed
tomography; MRI, magnetic resonance imaging.
Mesenteric thrombosis with infarction of the bowel may present with sudden
abdominal pain, vomiting, hematemesis or hematochezia, and shock. Exquisite
tenderness of the abdomen and absent bowel sounds are the major findings.
Hemorrhage from a ruptured aneurysm (mesenteric, hepatic, or renal) with
hemoperitoneum is heralded by sudden onset of severe pain, vomiting, tachycardia, and
shock. The abdomen is tender and tense, and bowel sounds are diminished or absent.
