Tight abdominal muscles

Introduction Abdominal tenderness, rebound tenderness and abdominal muscle tension are the main signs of abdominal organ rupture, which is a sign of peritoneal irritation. Generally caused by abdominal infection, perforation, obstruction, visceral injury bleeding and other reasons. The peritoneum is rich in nerves and blood vessels. The patient usually presents with severe pain that is unbearable in the abdomen, sweating, high fever, weakness, and speechlessness. A variety of diseases can cause peritoneal irritation. The onset is urgent, the vast majority can be cured, and very few can die because the treatment is not timely.

Cause

Causes

Can cause peritoneal inflammation, such as perforation of hollow organs, digestive juice into the abdominal cavity, trauma, infection and so on. The most common cause of rupture is pelvic and spinal fractures, accounting for about 2/3; followed by rupture of the retroperitoneal organs (kidney, bladder, duodenum, and pancreas) and major vascular and soft tissue injuries. Because it often combined with severe combined injury, hemorrhagic shock, etc., the mortality rate can reach 35 ~ 42%, a variety of diseases can cause more than 90% of peritoneal irritation caused by penetrating injury. Due to rapid and massive bleeding, most patients died on the scene, and the death rate after delivery to the hospital was 70%.

an examination

Related inspection

Abdominal skin examination, abdominal shape examination, abdominal plain film, choledochoscopy, abdominal vascular ultrasound examination

1. Tenderness and rebound tenderness are the main signs of peritonitis and always exist. The degree of abdominal muscle tension varies depending on the cause and the general condition of the patient. Abdominal percussion can be drum sounded due to flatulence. When the effusion in the peritoneal cavity is long, the mobile voiced sound can be extracted, and it can also be used to locate the necessary abdominal puncture. Auscultation often finds that the bowel sounds weaken or disappear.

2, laboratory and X-ray examination: blood routine white blood cell count increased, but when the condition is serious or the body's response is low, the white blood cell count can not be high. Abdominal X-ray examination showed that the intestine was generally flatulent and had multiple signs of intestinal paralysis such as a small gas level (should be in perspective). Laparoscopic examination and treatment of the abdominal cavity by laparoscopy.

Differential diagnosis

Identification

1. Acute peritonitis refers to acute inflammation of the peritoneum. Commonly found in the clinic is secondary, bacterial, diffuse peritonitis, often referred to as acute peritonitis.

2, liver damage refers to the liver rupture under the action of external forces, and trigger hemorrhagic shock, biliary peritonitis and secondary systemic infection.

3. Secondary peritonitis is mostly caused by inflammation, perforation, surgical complications or rupture of the intra-abdominal organs.

4. Abdominal pain in type 1 diabetes is a peritoneal irritation of acute abdomen.

The patient is usually characterized by severe pain that is unbearable in the abdomen, sweating, high fever, weakness, and non-verbal symptoms. Acute peritonitis, severe abdominal pain, abdominal wall tension, arch and abdomen. Abdominal palpation resistance, depression, chest breathing, elevated body temperature, decreased appetite, and sometimes vomiting symptoms.

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