Acute abdomen

Acute abdomen ( called among physicians and acute abdomen) is a term used in medicine. He referred to a mostly acute onset symptoms in many life-threatening diseases in the abdomen. The acute abdomen requires rapid diagnosis and often emergency surgical treatment. Typical symptoms are sudden severe abdominal pain, guarding of the abdominal wall muscles, changes in bowel function with disturbance of defecation as well as fever and in severe cases, signs of circulatory shock.

The term acute abdomen is initially a clinical- descriptive name. It must be clarified as soon as possible what the acute abdomen as the underlying cause and whether surgery is necessary.

Causes

In more than 90 percent of cases the acute abdomen caused by any of the following medical conditions:

• Acute appendicitis, colloquially " appendicitis " ( appendicitis)
• Acute gallbladder inflammation ( cholecystitis )
• Intestinal obstruction ( ileus)
• Renal colic
• Perforated gastric or duodenal ulcer ( intestinal perforation )
• Acute inflammation of the pancreas (pancreatitis )
• Diverticulitis

Other rare causes are simple gastric or duodenal ulcers, biliary colic, gall bladder or bowel perforation, pinched rupture ( hernia ), ruptured ( ruptured ) aneurysm, ectopic pregnancy, pelvic inflammatory disease, ovarian torsion, peritonitis, and other causes such as injuries to the abdominal organs and mesenteric infarction. In addition, can also be blunt trauma to the abdominal area the cause of an acute abdomen. There are also a variety of diseases that are associated with severe abdominal pain, the cause of which is not in the abdomen (myocardial infarction, etc.).

Symptoms

Pain

One can distinguish between three characters pain.

• Colicky pain indicate an obstruction.
• Pain with mild to moderate intensity, in which the patient can name the onset of pain is very inaccurate, are typical of inflammatory processes.
• Violent and sudden pain occur in perforations and the aortic aneurysm.

In addition to pain, which caused the abdominal cavity have projected in many cases in other parts of the body.

One calls this projection anatomical correlation.

Special forms of pain make the peritonitis and peritonitis dar.

Other symptoms

Pain described above are common to one or more of the following symptoms together:

• Nausea, vomiting
• Distended abdomen
• Possibly diarrhea (diarrhea) or constipation ( constipation)
• Fever

Diagnostics and Therapy

The investigation of an acute abdomen is urgent. In addition to history and physical examination are ultrasonography of the abdomen, laboratory diagnostics, endoscopic procedures (eg gastroscopy ) and imaging ( computed tomography ) are important diagnostic agents. Depending on the urgency, however, often lack the time for it, so without these surgical opening of the abdomen ( laparotomy ) or an endoscopic procedure in the abdominal cavity ( laparoscopy) must be performed. The latter is in doubt, include the diagnosis if collected findings are not sufficiently explicit.

Therapeutic initial measures are storage in posture ( dressed legs ), oxygen delivery, installation of large-bore peripheral venous access, fluid resuscitation and monitoring of heart rate, heart rhythm, blood pressure, respiratory rate and oxygen saturation.

Painkillers may, should and must be given. However, care must be taken in the choice and timing of administration, as early administered painkillers can disguise the cause or indication for surgery. When opioids continuing to exercise caution because they can cause spasms of the smooth muscles and thus aggravate the symptoms. Pethidine, however, must be given.