Approach to a patient with Acute Abdomen
Previously undiagnosed pain that arises suddenly having duration of 7 days (mostly less than 48 hours) and usually needs immediate surgical intervention.Causes according to ageNeonates: Intestinal atresia and stenosis, meconium ileus, meconium peritonitis, imperforate anus, annular pancreasInfants: Volvulus, Intussusception, Meckel’s diverticulitisChildren: Round worm infestation, Appendicitis, Mesenteric lymphadenitis Adults: Appendicitis, Meckel's Diverticulitis, Perforation of peptic ulcer, Acute Cholecystitis, Acute pancreatitisElderly: Sigmoid volvulus, Intestinal obstruction from malignant growth, diverticulitisHistoryTime of onsetPain starts early in the morning → Acute appendicitisMode of onsetSudden: Perforation, colic, volvulus and torsionGradual: ObstructionReferred pain:T5 to T8 → foregut → Epigastric painT9 to T10 → midgut → umbilical painT11, 12 L1, 2 → Hindgut → Suprapubic painshoulder pain → Referred from diaphragmshoulder pain → Referred from spleen (Kehr’s sign)K…
