Definition: (Acute Abdomen)
This is a term used to define a group of abdominal conditions in which early surgical treatment must be considered.
Few medical conditions mimic surgical conditions and sometime un-necessary surgery is performed e.g;
Some patient with myocardial infarction just present with epigastric pain and vomiting.
Patient of diabetes ketoacidosis or porphyria may present with abdominal pain.
Cases in Surgical Emergency present with abdominal pain:
Pain due to Inflammation:
Pelvic inflammation disease.
Pain due to Perforation:
Pain due to Vascular Ischemia:
Ruptured aortic aneurysm.
Pain due to Obstruction:
Cases in Medical Emergency present with Abdominal pain:
Functional Gastrointestinal Disorders:
Irritable Bowel Syndrome.
Sickle cell crisis.
Mechanism of Abdominal pain:
- Visceral pain.
- Referred pain.
1. Visceral pain:
Irritation or Inflammation of peritoneum.
Spasm of hallow viscus.
Stretching of capsule of solid organs.
Ulceration of tissues.
2. Referred pain:
From the chest.
From the vertebral column.
From the Gonads.
Diagnosis of Abdominal Pain:
Take pain history from the patient like, onset, nature and other features.
Ask about other symptoms history like, Nausea & Vomiting.
Check the sign of Peritonitis and Obstruction;
Distension of abdomen due to gas.
Increased gut sounds.
Absent gut sounds suggest peritonitis.
Pelvic and Rectal Examination:
Pelvic examination for gynaecological disorder e.g; Ruptured ectopic pregnancy.
Rectal examination to detect localized tenderness.
Management perform according to underlying cause of abdominal pain.