Acute Abdomen: Causes, Symptoms & Treatment

The sudden onset of gastrointestinal illness is reflected in various abnormalities, which can be used for diagnostic purposes. Acute abdomen is usually an indication that prompt medical action is needed.

What is an acute abdomen?

Acute abdomen is about painful discomfort, which occurs primarily in the zone of the abdomen. The term acute abdomen is not an independent disease, but describes a complex of several symptoms. Therefore, in modern medicine it is often referred to as a syndrome. Acute abdomen is a painful condition that occurs primarily in the abdominal region. Therefore, acute abdomen is the “sudden or acute abdomen”. In acute abdomen, varying types of painful sensations are perceived, which may be a helpful clue for finding a diagnosis. Acute abdomen may also mask a life-threatening condition.

Causes

When acute abdomen occurs, different causes must be questioned. The causes may be either internal or external to the abdomen. Specifically, organic diseases such as a peptic ulcer or ulcer, appendicitis or gallbladder inflammation, a tumor, ulcerative colitis, or inflammation of the diverticula in the colon may be behind an acute abdomen. Other diseases that contribute to an acute abdomen are diseases of the internal female reproductive organs, a deficiency of blood supply to the intestine, an inflammation of the abdominal cavity, pancreatitis and a myocardial infarction, as well as kidney and biliary colic. Obstructions of the urinary tract due to stones, pregnancy outside the uterus, hernias, carcinomas or adhesions and intestinal obstruction are also the typical diseases that can be associated with acute abdomen. Pain from Crohn’s disease and from inflammation of the ovaries and tumors of the kidneys also radiate into the abdomen.

Symptoms, complaints, and signs

Acute abdomen is characterized by sudden onset of severe abdominal pain. In this case, the abdominal wall often exhibits reflex defensive tension on palpation of the abdomen, which is manifested by a board-hard abdomen. The abdominal pain is often accompanied by nausea, vomiting, defecation, diarrhea, flatulence, and fever. In severe cases, circulatory shock may also occur. Depending on the cause, abdominal pain in acute abdomen occurs in three different forms. Thus, there is visceral pain, colic pain and somatic pain. Visceral pain is initially manifested by a well-localizable sudden and cramp-like pain attack. As it progresses, however, this pain becomes diffuse, dull, and burning. It can then no longer be localized. Visceral pain is typical in inflammation and ulceration of hollow organs. Colic refers to another type of pain that is characterized by a cramp-like waxing and waning process. The patient obtains relief by writhing. This type of pain occurs with intestinal obstruction and with gallstones or urinary stones. Somatic pain is a cutting pain that worsens with movement. Initially, it appears to be easily localized. However, as inflammation spreads to various internal organs such as the pancreas, appendix, or gallbladder, the pain becomes more diffuse. Depending on the cause of the acute abdomen, both uncomplicated and complicated courses may occur.

Diagnosis and course

In acute abdomen, sufferers complain of sudden onset of abdominal pain, which may intensify to abdominal cramps. The creek usually appears firm and tense on palpation. In addition, even in acute abdomen, the pain is either localized or involves the entire abdominal surface. This clarification already makes a diagnosis much easier. By using the stethoscope and various palpation techniques, the physician can usually directly determine the areas of pain in acute abdomen. An accurate history and description of symptoms by the patient are also important for the diagnosis. Subsequent medical examinations such as computer tomography, ultrasound and endoscopy can be used for precise differential diagnosis.These diagnostic methods in acute abdomen are completed by laboratory tests with blood, serum, and excretions, as well as the radiographs.

Complications

Acute abdomen can cause several complications as the disease progresses. First, there is a risk that the dying tissue will become inflamed and cause further infections and abscesses in the abdomen. An acute abdomen in the gastric region can lead to congestion and the spread of germs into the abdominal cavity; for example, in the case of a rupture or due to an inflamed abdomen near the internal organs. This can subsequently lead to sepsis, which in turn can lead to various complications (fever, organ failure ). Acute abdomen in the gastrointestinal tract may furthermore lead to occlusion of blood vessels or entrapment of intestinal loops, which in extreme cases leads to death of the surrounding tissue. Injured blood vessels can cause severe shock due to increased blood loss, which can also result in death. Severe complications such as these can occur either without external intervention or as part of a surgical procedure. Especially in the case of a pronounced abdomen, common procedures such as keyhole surgery can quickly lead to further injury to the intestinal tissue. In addition, there is a risk of allergic reactions to prescribed medications.

When should you go to the doctor?

In this disease, an urgent visit to a doctor is necessary. In most cases, however, the symptoms are not particularly characteristic of the disease, so only a delayed diagnosis can be made. However, patients should definitely consult a doctor in case of prolonged complaints. Therefore, if there is significant pain and cramps in the abdomen and fever, treatment must be provided. Similarly, constipation and diarrhea may indicate the disease. The pain in this case is usually sharp and not infrequently spreads to other regions of the body. If no treatment is given, in the worst case the patient’s organs may fail. This often leads directly to the death of the affected person. If the affected person is not sure about the symptoms, a general practitioner can be consulted first. In acute emergencies or very severe pain, a hospital should be visited or an emergency physician should be called.

Treatment and therapy

The start of treatment for acute abdomen should be initiated as soon as possible. In itself, acute abdomen sometimes hides unexpected complications. These should be recognized and ruled out in time. Since most of the causes of acute abdomen are inflammatory diseases of the organs, they are treated with the conventional and, if necessary, surgical methods. If an acute abdomen involves internal bleeding, stabilization of vital signs and stopping the sources of bleeding are the first priority in an inpatient setting. If occlusions of organs or entrapments of intestinal passages have proven to be the cause of the acute abdomen, the blood supply to these organs must be restored immediately. The general condition of the patient must be kept stable. Medications can be administered either orally or by infusion. In most cases of those affected, an acute abdomen means a stay in a clinic. Once the causes are found, permanent monitoring of the health condition and appropriate therapy for acute abdomen can then be provided on site.

Outlook and prognosis

The outlook and prognosis for acute abdomen depend on two factors: Cause of the acute abdomen and timing of diagnosis. In general, the underlying conditions of acute abdomen are fatal unless treated. Examples include appendicitis (inflammation of the appendix), intestinal obstruction, perforation of the bowel, or renal colic. If one of the causative diseases is not treated in time, the patient may suffer from the consequences for the rest of his or her life. Appendicitis is once again mentioned as an example: a ruptured appendix floods the abdominal cavity with inflammatory fluid, and it is usually not possible to clean out the abdominal cavity completely. Pain and a reduction in quality of life are the consequences. If the cause of the acute abdomen is recognized in time and treated accordingly, the prognosis is very good.As a rule, the causes can be completely eliminated by means of surgery and subside completely in the further course. Since the cause of acute abdomen can usually be diagnosed quickly and correctly, the prognosis is very good.

Prevention

Acute abdomen occurs unexpectedly. Sometimes there is painful discomfort now and then that always goes away on its own, and it takes a while for acute abdomen to form then. Often, however, there are no precursors to acute abdomen. There is no preventive approach to acute abdomen because acute abdomen develops in unity with an underlying disease.

Here’s what you can do yourself

In most cases, acute abdomen requires immediate, often even emergency medical treatment. Otherwise, affected individuals may go into a life-threatening state of shock. Attempts at self-treatment should not be made here. In the case of necessary operations, patients can only support the healing process postoperatively. The possible measures are also advisable to accompany conservative treatment. These include strict bed rest for the first few days and adequate fluid intake. Depending on whether diarrhea and/or vomiting occur as symptoms, care must also be taken to balance minerals. Unsweetened herbal teas and still mineral waters are recommended. Taking additional dietary supplements may be advisable in this context: potassium, magnesium, zinc and selenium have an anti-inflammatory effect. Solid food should be avoided for the first few days, and a dietary regimen is also advisable for the following weeks. Vegetable broths and later also chicken soups give the organism strength and compensate for fluid and mineral deficiencies. Slowly, various vegetables and carbohydrates can be added to the diet. Affected persons should chew the food very well and take it in small quantities throughout the day. To support a mostly ordered antibiotic treatment, the intake of probiotics is advised. When the general condition improves, small walks in the fresh air should be started. These stimulate the entire gastrointestinal tract and boost the immune system.