Acute Abdomen: Symptoms, Causes, Treatment

In acute abdomen – colloquially called acute abdomen – (synonyms: Abdominal rigidity with severe abdominal pain; severe abdominal pain with abdominal tension; ICD-10-GM R10.0: acute abdomen) is a symptom complex characterized by the following involved symptoms:

  • Abdominal pain (abdominal tenderness) – acute onset or pain that persists progressively over 24 h.
  • Defensive tension (due to peritonitis/peritonitis).
  • Disturbance of intestinal peristalsis: possibly paralytic ileus/paralytic intestinal obstruction (absent bowel sounds, possibly meteorism/ flatulence); nausea (nausea)/vomiting.
  • Circulatory disturbances up to the shock symptomatology

Acute abdomen can have multiple causes and can be triggered by various intra- or extra-abdominal diseases:

The so-called NASP (non-specific abdominal pain) is considered the cause of acute abdomen in about 30% of cases. This is abdominal discomfort for which no identifiable cause can be found (= uncharacteristic abdominal pain). As a rule, the complaints subside within 48 hours. They occur much more frequently in patients under 50 years of age than in older patients.

Approximately 10% of all patients who visit an emergency department today come because of abdominal pain; however, only about 20% of these patients meet the criteria for an acute abdomen (see above).

The prevalence of acute abdominal pain is 0.13% of the population (per year) in Germany. Approximately 1 million people are affected.

Acute abdomen can be a symptom of many diseases (see “Differential diagnoses” below).

Course and prognosis: Immediate hospitalization. Diagnostic and therapeutic measures should be taken immediately, since acute abdomen is an acutely life-threatening clinical picture! If diffuse peritonitis (inflammation of the peritoneum extending to the entire abdominal cavity) exists and the patient’s general condition is impaired, immediate surgical exploration (operation to clarify the facts) is required. Approximately one-fourth of those affected require surgery.