Acute Abdomen - Causes and Symptoms

Definition

The acute abdomen is a clinical picture with a rapid, sudden and violent onset, whose predominant symptom is represented by abdominal pain, localized in a point or diffuse. In any case, the severity and intensity of the symptomatology is such as to require or suggest a surgical treatment.

The causes are numerous.

Often, the symptomatology depends on the rapid establishment of any pathological process affecting the various organs and systems contained in the abdominal cavity. In general, the pain syndromes in this region can be considered as the expression of serious complications during acute inflammation, obstruction, perforation of hollow viscera or vascular accidents. In some cases, the acute abdomen is a consequence of abdominal disorders.

Acute abdomen from inflammation

The symptomatology that characterizes the acute abdomen from phlogosis arises from the parietal peritoneum, innervated by somatic nerves, which are in turn sensitive to irritation caused by infectious, chemical or other acute inflammatory causes. The pain is somatic, violent and well localized, with the absence or diminution of peristalsis.

The acute inflammatory abdomen can result from the complication of appendicitis, cholecystitis, pancreatitis, adnexitis, gastroduodenitis, cystitis, diverticulitis and peritonitis.

Sharp abdomen from obstruction

The acute occlusive abdomen originates from the abdominal viscera, which are innervated by fibers of the autonomic nervous system and are sensitive to muscle distension and contraction. Acute abdominal pain of a visceral type is typically vague, dull and accompanied by nausea and hyperperistaltism.

In this context, the acute abdomen can derive from intestinal occlusions of various kinds, obstruction of the biliary and urinary tract and torsion of viscera - such as spleen, ovaries or testicles - on their peduncle.

Acute abdomen from perforation or from vascular accident

The acute abdomen from perforation or from vascular accident causes a very intense visceral pain, with hyperperistaltismo and evolution in a peritonitic form (infarct phase).

The symptomalogical picture may also occur in the case of peptic ulcer, intestinal neoplasm, rupture of the spleen or abdominal aortic aneurysms or visceral arteries. Furthermore, it may be due to traumatic injuries, the presence of a foreign body, dehiscence of surgical stumps, mesenteric infarction and necrosis of the intestine.

Other causes are gynecological and include ectopic pregnancy and ovarian cysts in the rupture phase.

Other out-of-abdominal causes

Acute pain can be perceived at a distance from its origin, therefore it can derive from pathologies affecting foreign bodies in the abdominal cavity. The symptomatology results from the convergence of the nerve fibers at the level of the spinal cord.

The acute abdomen can present in the case of myocardial infarction, renal colic and acetone crisis. Basal pneumonia, aortic dissection, drepanocytosis, porphyria and some forms of decompensated diabetes can also occur with this clinical picture.

Associated symptoms

In relation to the cause, the symptoms associated with the acute abdomen include nausea, repeated biliary or alimentary vomiting, pallor or sweating and motor restlessness.

The clinical signs can be represented by peristalsis alterations, an important defense contracture evoked by palpation, distension or swelling of the abdomen, high pulse frequency, dehydration, hypotension, oliguria and dysuria, increase in white blood cells and fever.

The initial site and the ways in which pain is spread often have diagnostic value.

Acute pseudo-abdomen

Some medical and / or functional pathologies can simulate a picture of acute abdomen. These include gastroenteritis, acute hepatitis, mesenteric lymphadenitis and painful ovulation.

Only a thorough medical history and in-depth diagnostic tests can clarify the presence or absence of a pathological condition that constitutes a medical emergency.