Acute Abdomen

Definition

“Acute abdomen” is the medical term used for pain in the abdomen that usually comes on suddenly and is so severe that one may have to go to the hospital. As opposed to common abdominal pain, which can be caused by minor issues such as constipation or gas, acute abdominal pain can signal a variety of more serious conditions, some of which require immediate medical care and/or surgery. Therefore, if you suspect you have this condition, contact your doctor immediately.

Abdominal Organs, Anterior View

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Causes

There are a number of possible causes of acute abdomen. These include:

• Viral gastroenteritis —stomach flu
• Intestinal obstruction
• Hernia
• Appendicitis —inflammation of the appendix
• Pancreatitis —inflammation of the pancreas
• Diverticulitis —inflammation of small pouches that form in the large intestine
• Cholecystitis—inflammation of the gallbladder, with or without gallstones
• Cholangitis—inflammation of the bile duct caused by a gallstone or a bacterial infection
• Gastritis —inflammation of the stomach lining, such as from drinking too much alcohol or prolonged use of nonsteroidal anti-inflammatory drugs (NSAIDs)
• Kidney, bladder, or urinary tract infection
• Kidney stones
• Ulcerative colitis or Crohn’s disease —inflammatory diseases of the intestines
• Sickle cell crisis
• Diabetic ketoacidosis—dangerously high levels of acids in the blood
• Ruptured or leaking abdominal aortic aneurysm —abnormally large blood vessels in the abdomen
• Ischemia—inadequate, or blocked, blood supply to one of the abdominal organs
• Infectious diarrhea
• Irritable bowel syndrome (IBS)
• Heartburn or gastroesophageal reflux disease (GERD)
• Peptic ulcer
• Heart attack
• Cancer
• Pneumonia
• In women:
  • Menstrual cramps
  • Endometriosis
  • Uterine fibroids
  • Ovarian cysts
  • Pelvic inflammatory disease —inflammation around the ovaries, uterus, and fallopian tubes
  • Miscarriage or ectopic pregnancy
• In infants:
  • Intussusception (the telescoping of one portion of the intestine into another, causing obstruction of the bowel and blockage of its blood flow)
  • Volvulus—a twisting of the colon around itself
  • Hirschsprung's disease —also known as congenital megacolon
  • Other congenital defects of the digestive tract

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition. Risk factors for acute abdomen include the following:

• Infancy or childhood
• Increased age

Symptoms

The symptoms of acute abdomen have a variety of causes. If you experience any one of them, see your physician.

• Persistent, severe pain, swelling, and/or tenderness in the upper, middle, or lower abdomen
• Guarding—involuntary contraction of the abdominal muscles
• Rigidity—when abdominal muscles are tense and board-like
• Fever

Diagnosis

Your doctor will ask you for details about your pain, such as the exact location and duration, and about any additional symptoms you may be experiencing, such as bowel or urinary symptoms. He or she will also take your medical history, including any drugs or medications you’ve taken, and perform a physical exam, including rectal and pelvic examinations.

Additionally, one or more of the following tests may be necessary to make a diagnosis:

• Blood tests
• Urine analysis
• Liver function tests
• Ultrasound —a test that uses sound waves to examine the abdomen
• CT scan —a type of x-ray that uses a computer to make pictures of structures inside the abdomen
• MRI scan —a test that uses magnetic waves to make pictures of structures inside the abdomen
• KUB (kidney, ureter, and bladder) x-rays
• Barium x-rays
• Angiography
• Surgery
• Endoscopy—a thin, lighted tube inserted down the throat to examine the abdominal area

Treatment

For symptom relief, mild analgesics may be prescribed to reduce pain, however many doctors forgo prescribing painkillers since details of the pain can be useful in determining its cause. Do not take any medication such as Tylenol or ibuprofen, and do not eat or drink until you have spoken with your doctor.

Talk with your doctor about the best treatment plan for you. Depending on the underlying condition causing your acute abdomen, treatment options may include:

• Antibiotics
• Avoidance of certain foods, beverages, or medicines
• Surgery—may be required for the majority of severe abdominal pains that last for at least six hours in previously healthy patients

Prevention

Depending on the underlying condition causing acute abdomen, prevention measures will vary. Talk with your doctor about preventing conditions that cause acute abdomen.