Differential diagnosis of inflammatory and ileal acute abdomen

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Non-traumatic acute abdomen (AA) is divided into:

  1. inflammatory,
  2. ileus,
  3. gastrointestinal bleeding,
  4. gynecological and
  5. perioperative.

Typical symptoms of inflammatory acute abdomen[edit | edit source]


  • pain persistent, initially visceral (dull, imprecisely localized), later somatic (sharp, localized).
Searchtool right.svg For more information see Types of pain in acute abdomen.


  • patient maintains an unchanging position, afraid to cough,
  • limitation of breathing wave progression,
  • abdominal muscular wall contraction (défense musculaire),
  • in inflammation of the lower abdomen and small pelvis, painful per rectum examination,
  • signs of peritoneal irritation (Plenies, Blumberg, Rovsing).

Laboratory and other findings:

  • Increase in body temperature, heart rate, leukocytosis, ↑ FW and CRP (i.e., general inflammatory manifestations).

Typical symptoms of ileus acute abdomen[edit | edit source]


Searchtool right.svg For more information see Ileus.
  • vomiting is common (reflex vomiting at the beginning, later from the accumulation of contents),
  • stopping the passage of gas and stool.


  • the patient frequently changes position, sometimes squeezes his abdomen,
  • the abdominal wall is distended, tense, but not contracted,
  • the abdomen breathes in its entirety,
  • drum percussion,
  • listening to the amplification of peristalsis, regular sounds, later ceases (and in paralytic ileus at the beginning),
  • per rectum examination mostly painless.

Laboratory and other findings:

  • sometimes acceleration of heart rate, body temperature, and leukocytes tend to be normal.

The two basic types of Acute abdomen can intermingle – inflammation is complicated by paralytic ileus, ileus is complicated by inflammation (peritonitis from perforation).

References[edit | edit source]

External links[edit | edit source]

  • As. MUDr. Petr Růžička: Ileous acute abdomen E-learning

Related articles[edit | edit source]

Source[edit | edit source]