Distended Abdomen
The Problem:
Abdominal distention is a common problem on neuro wards. It can be due to benign motility problems or constipation but can also be a symptom of a ruptured viscus, intra-abdominal infection, bowel infarction, or other major pathology. Remember that stuperous patients and those with cord impairments may not report pain. Remember too that nasogastric tubes should be inserted with great caution in patients with anterior fossa basal skull fractures because they might be shown by later x-rays to have entered the brain!
What We Do:
After reviewing the chart and determining relevant hx and physical findings, consider the following :
  • blood tests including CBC, CR, urea, lytes, LFT's, Ca++>, albumin
  • 3 views of the abdomen to look for free air and for distended bowel loops
  • NG to low suction
  • NPO
  • C & S urine and feces
  • Add laxative or motility agent such as motilium
  • Get help from gen surg if acute abdomen suspected


Links:
the links

Evidence Footnotes:
1. reference

Authorship: Dr Valerie Taylor Last Revised: 29 May 2002
 
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