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Acute abdomen is the abrupt appearance of acute abdominal pain.[1] An acute abdomen describes an intra-abdominal pathology that has an onset of less than one week and may require immediate intervention, including surgery.[2]
Causes
[edit]The most common causes of acute abdomen are as follows:[3]
Abdominal causes of acute abdomen
[edit]Gastrointestinal
[edit]- Appendicitis[3]
- Perforated peptic ulcer[3]
- Intestinal obstruction[3]
- Intestinal perforation[3]
- Intestinal ischemia[3]
- Colonic diverticulitis[3]
- Meckel diverticulitis[3]
- Inflammatory bowel disease[3]
Pancreatic, biliary, hepatic, and splenic
[edit]- Acute pancreatitis[3]
- Acute cholecystitis[3]
- Hepatic abscess[3]
- Ruptured or hemorrhagic hepatic tumor[3]
- Acute hepatitis[3]
- Acute cholangitis[3]
- Splenic rupture[3]
Urological
[edit]Retroperitoneal
[edit]Gynecological
[edit]- Ruptured ovarian cyst[3]
- Ovarian torsion[3]
- Ectopic pregnancy[3]
- Acute salpingitis[3]
- Pyosalpinx[3]
- Endometritis[3]
- Uterine rupture[3]
Abdominal wall
[edit]- Rectus muscle hematoma[3]
Extraabdominal causes of acute abdomen
[edit]Thoracic
[edit]- Myocardial infarction[3]
- Acute pericarditis[3]
- Lower lobe pneumonia[3]
- Pneumothorax[3]
- Pulmonary infarction[3]
Hematological
[edit]Neurological
[edit]Metabolic
[edit]Drug-related
[edit]Mechanism
[edit]Visceral pain is poorly localized and perceived, depending on the structure/organ's embryological origin. Pain from the foregut viscera (stomach, duodenum, pancreas, gallbladder, and liver) is transmitted to the epigastrium via the coeliac plexus. The midgut viscera sends pain to the umbilicus via the superior mesenteric plexus. Pain is transmitted from the hindgut viscera to the hypogastric region through the inferior mesenteric plexus. Parietal pain is caused by direct peritoneal irritation mediated by somatic nerves (thoraco-lumbar) and may be accompanied by reflex abdominal wall rigidity. Diaphragmatic irritation, such as from acute cholecystitis, affects the shoulder.[4]
Diagnostic approach
[edit]Treatment
[edit]Epidemiology
[edit]See also
[edit]References
[edit]- ^ Nassar, Aussama K.; Spain, David A.; Davis, Kimberly (2022). "Assessment of the Patients with an Acute Abdomen". The Acute Management of Surgical Disease. Cham: Springer International Publishing. p. 17–27. doi:10.1007/978-3-031-07881-1_2. ISBN 978-3-031-07880-4.
- ^ Langell, John T.; Mulvihill, Sean J. (2008). "Gastrointestinal Perforation and the Acute Abdomen". Medical Clinics of North America. 92 (3): 599–625. doi:10.1016/j.mcna.2007.12.004.
- ^ a b c d e f g h i j k l m n o p q r s t u v w x y z aa ab ac ad ae af ag ah ai aj ak al am an ao ap aq ar Minter, Rebecca M.; Mulholland, Michael W. (2008-05-30). "Approach to the Patient with Acute Abdomen". Principles of Clinical Gastroenterology. Wiley. p. 271–286. doi:10.1002/9781444300758.ch16. ISBN 978-1-4051-6910-3.
- ^ Tillney, Henry; Heriot, Alexander G. (2009-02-16). "Acute abdomen". In Aziz, Omer; Paraskeva Paraskevas (eds.). Hospital Surgery: Foundations in Surgical Practice. Cambridge University Press. pp. 202–206. doi:10.1017/cbo9780511575747.035. ISBN 978-0-521-68205-3.