Acute abdomen

Acute Abdomen are serious conditions that arise suddenly, from full health, and have a very rapid course. Without timely treatment, they can be life-threatening. An important criterion for subsequent treatment is a quick but accurate determination of the underlying diagnosis. All examinations must be carried out thoroughly and systematically.

Accidental acute abdomen

 * rupture of parenchymal organs (hemoperitoneum)
 * perforation of hollow organs
 * mixed form

Non-accidental acute abdomen

 * inflammatory (limited to the organ/with transition to the surroundings, diffuse peritonitis)
 * ileus (mechanical/ neurogenic/ vascular ileus)
 * vascular - venous thrombosis, arterial embolization, bleeding into the GIT

Symptomatology

 * pain
 * subfebrile, or febrile
 * tachycardia, tachypnoea
 * nausea, vomiting
 * abdominal distension
 * stiff, tense abdominal wall
 * patient position
 * gas and stool disorders

Anamnesis

 * CC (chief complaint) – development and nature of difficulties, time of onset of difficulties
 * Illnesses, operations, traumas
 * Allergies
 * Family diseases
 * Past medical history
 * Social history (medicine), including living arrangements, occupation, marital status, number of children, drug use (including tobacco, alcohol, other recreational drug use), working conditions
 * GA – in woman (Sexual history, obstetric/gynecological)


 * 1) direct - taken from the patient
 * 2) indirect - taken from family, paramedics, friends...

Clinical examination
View
 * we always examine the entire abdomen, from the nipples to the inguinal ligaments (signs of a hernia)
 * we observe the level of the abdomen - whether it is raised or sunken
 * we notice wounds, bruises, scars
 * we observe peristaltic waves
 * we observe the breath wave
 * abdominal configuration

Feel
 * we start the investigation on the opposite side from the pain
 * we detect muscle contraction, resistance and soreness
 * border of liver and spleen
 * surface palpation with the whole hand, palpation with 1 or 2 fingers, deep palpation

Percussion
 * differentiated tympanic
 * tympanic
 * dark
 * we notice a painful tap

Listening
 * silence
 * irregular sounds
 * strenuous peristalsis
 * the sound of a drop falling
 * splash

Examination per rectum
 * surroundings of anus
 * pain
 * sphincter tone
 * stool
 * bleeding

Paraclinical examination

 * X-ray – use of contrast material / native image of the abdomen (standing)
 * USG
 * CT
 * colonoscopy
 * ECG
 * laboratory examination – urine, blood count, hematocrit, sedimentation, biochemical blood analysis

Related Articles

 * Objective symptoms of acute abdomen
 * Subjective signs of acute abdomen
 * Differential diagnosis of inflammatory and ileal acute abdomen
 * Acute abdomen in gynecology
 * Acute abdomen in children
 * Differential diagnosis of ileous conditions
 * Types of pain in acute abdomen
 * Diagnostic imaging of the acute abdomen