Acute abdomen

Acute abdomen
● Acute abdomen means the patient complains of
acute attack of abdominal pain that may occur
suddenly or gradually over period of several hours
and presents a symptoms complex which suggests
a disease that possibly threatens life.

● it may (resulting from inflammation,obstruction,

infarction,perforation ,or rupture of intra
abdominal organs).
Acute abdomen requires urgent
evaluation and diagnosis because
it may indicate a condition that
requires urgent surgical
intervention.
 Etiology
There are many underlying conditions for acute abdomen, some are
trivial, but some are immediately life threatening, requiring rapid
diagnosis and surgery. These include:

- Acute appendicitis ( most common )

- Cholecystitis
- Pancreatitis
- Mesenteric ischemia and ruptured abdominal aortic aneurysm.
- Ruptured ectopic pregnancy and ovarian torsion
- Small bowel obstruction
- Newborns can present with necrotizing enterocolitis.
 Clinical sequences
● Unstable vital signs: hypotension, tachycardia

● Pain characteristics:
1. Sudden onset of severe pain
2. Pain that interrupts sleep
3. Pain out of proportion to abdominal findings

● Accompanying symptoms:
1. Bilious vomiting, nausea
2. Hematemesis, hematochezia
3. Jaundice
4. Anorexia
 Clinical sequences
● Findings on examination :

1. Possible peritoneal signs ; loss of body fluid into peritoneal

cavity
2. Guarding and/or rigidity (focal or diffused)
3. Rebound tenderness (focal or diffused)
4. Absent or tinkling bowel sounds
5. Gross abdominal distention
Differential Diagnosis
 Diagnosis
Lab tests :
● Complete blood count (CBC)
● Comprehensive metabolic panel (CMP)
● Lipase
● Lactate ; For sepsis or mesenteric ischemia
● A urine or serum pregnancy test is needed in the workup
of ectopic pregnancy.

Other investigations :
● X-ray
● Abdominal ultrasonography
● CT scan
 Treatment
Drug Therapy :
● large bore IV access for hypotension and tachycardia
● Broad-spectrum IV antibiotics should be administered in a
timely fashion when infection, peritoneal soilage, or sepsis is
in the differential.
● Adequate pain relief with opioids is a standard of care.
● Anti-emetics.

Surgical Therapy :
Some abdominal diseases originally suited for medical therapy
may require surgical therapy because a patient's clinical status
worsens or secondary complications develop.
Done by :

● Shahad Anad
● Hajar Ayed
● Renad Salem
● Lamis Rahim
Thanks