Acute Abdomen: Causes and Cures

Acute abdomen is a clinical condition, of rapid onset, characterised by abdominal pain, more or less localised, which may lead, considering its severity, to surgical intervention, even on an emergency basis

The clinical picture is characterised by intense abdominal pain, which is often associated with fever, intestinal transit disorders, nausea, vomiting, sweating, feeling of exhaustion, motor restlessness.

Haematochemical tests often show leukocytosis with marked neutrophilia, increased CRP. and possible alteration of organ-related indices.

In general, we can say that the clinical picture of acute abdomen is the expression of important complications of various types at the abdominal level, which can be of a phlogistic nature such as: complicated appendicitis, cholecystitis, diverticulitis, pancreatitis, all of which can evolve into a state of peritonitis.

Other pathologies that can lead to a picture of an acute abdomen are intestinal obstructive pathologies that can be of various kinds such as the outcome of benign pathologies or the evolution of a neoplastic intestinal pathology or the twisting of the viscera on its axis.

Other important occurrences are perforation pathologies that may include the gastrointestinal or colic tract, complications that lead to emergency surgery.

Of the same severity, even greater, are vascular causes that may be obstructive in the vascular tree leading to the so-called intestinal infarction or haemorrhagic pathologies from ruptured spleen or ruptured abdominal aorta aneurysms.

Other causes of acute abdomen

Other causes may be gynaecological ones due to inflammatory processes of the adnexa, complicated ovarian cysts, ectopic pregnancies.

Rarely, a picture similar to the acute abdomen may be an expression of medical abdominal pathologies such as gastroenteritis, acute hepatitis, painful ovulation, or pathologies affecting organs outside the abdominal cavity, such as: myocardial infarction, pneumonia, dissection of the thoracic aorta.

Of utmost importance in attempting to make a correct differential diagnosis is the diagnostic imaging through the use of: direct X-ray of the abdomen, abdominal ultrasound and abdominal CT scan with mdc, investigations that must try to define, together with a careful clinical assessment of the patient, the nature of the picture, indicate the need for any surgical intervention, the type of intervention and try to identify the best timing to obtain the best possible result and the lowest risks for the patient.

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