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Acute Abdomen — Emergency Approach

Acute abdomen is a clinical syndrome of sudden severe abdominal pain that often requires urgent surgical or interventional decision-making.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Acil Servis department. Book Appointment →

What is Acute Abdomen — Emergency Approach?

Acute abdomen is a clinical syndrome characterised by sudden onset (<7 days) of severe abdominal pain that frequently requires urgent surgical or interventional management.

Common causes include acute appendicitis, perforated peptic ulcer, acute cholecystitis, acute pancreatitis, intestinal obstruction, mesenteric ischaemia, ruptured ectopic pregnancy and ruptured abdominal aortic aneurysm.

Diagnosis is based on focused history (onset, location, radiation, character, modifying factors), thorough abdominal examination (inspection, auscultation, palpation, percussion), laboratory tests and targeted imaging.

Time-critical conditions (perforation, ischaemia, ruptured aneurysm) require immediate surgical consultation and resuscitation. Computed tomography is the imaging modality of choice for the haemodynamically stable patient.

Symptoms

Sudden severe abdominal pain (visceral, somatic or referred)
Rebound tenderness, guarding, rigidity (peritonitis)
Nausea, vomiting (bilious, faeculent or coffee-ground)
Distension, absence of bowel sounds, obstipation
Fever, tachycardia, hypotension (sepsis or shock)
Abdominal mass, pulsatile mass (aortic aneurysm)
Cullen and Grey-Turner signs (haemorrhagic pancreatitis or retroperitoneal bleed)

Risk Factors

Older age (mesenteric ischaemia, malignancy, aortic aneurysm)
Atrial fibrillation, atherosclerosis, low-flow states (mesenteric ischaemia)
Prior abdominal surgery (adhesional obstruction)
NSAIDs, steroids, smoking (peptic ulcer perforation)
Alcohol abuse, gallstones (acute pancreatitis)
Pregnancy, IUD use, prior PID (ectopic pregnancy)
Inflammatory bowel disease, diverticulosis, immunosuppression

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Severe abdominal pain lasting >6 hours requires emergency evaluation
  • Pain with vomiting, fever, distension or rectal bleeding is alarm sign
  • Sudden tearing pain radiating to back (aortic dissection or rupture)
  • Pain in pregnant women — always exclude ectopic and emergencies
  • Shock signs (cold sweat, hypotension, syncope) require immediate 112

Treatment Methods

01
Initial resuscitation: ABCDE, intravenous access, crystalloid bolus, oxygen, monitoring
02
Nil by mouth (NPO), nasogastric decompression for obstruction or distension
03
Broad-spectrum antibiotics for suspected perforation or sepsis
04
Analgesia (intravenous opioids titrated) — does not mask diagnosis
05
CT abdomen-pelvis with contrast for stable patients to determine cause
06
Emergency surgical or interventional consultation for perforation, ischaemia or rupture
07
Targeted definitive treatment: appendicectomy, cholecystectomy, vascular surgery, etc.

Which Department to Visit?

You can visit our Acil Servis department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.