Guidelines | Acute abdomen


If an acute abdomen is suspected, a systematic and rapid procedure is necessary. This means that an acute abdomen requires “acute action”, since a decision must be made quickly whether surgery is necessary. The first step is always the patient interview (anamnesis), which can provide important information about the cause of the symptoms.

This is followed by the clinical examination of the patient, in which not only the examination of the abdomen and the rectal examination play a role, but also the general situation and the circulatory situation (heart rate and blood pressure) of the patient is taken into account. In addition, blood and urine are examined. A pregnancy test should be performed on a female patient.

In order to depict the exact situation in the abdominal cavity, nowadays, apparatus-based techniques are used. These include: In addition, an x-ray of the thorax can provide information on the causes of the complaints outside the abdominal cavity. Depending on the suspected diagnosis of the treating physician, further examinations may also be necessary.

It is crucial that the use of the apparatus techniques does not cause any delay, as there is an acute compulsion to act in the case of an acute abdomen. During all these steps, despite severe pain, no pain therapy should be performed until the cause of the acute abdomen is known. This could obscure symptoms that are important clues to the cause and hide a worsening of the condition.

After going through the steps of anamnesis, clinical examination and imaging procedures, about 90% of those affected undergo surgery. At the beginning, the patient should be given two catheters in two veins (i.v. access) so that fluid and medication can be administered quickly if necessary.

Depending on the severity of the clinical picture, the abdominal cavity can be opened within the scope of an operation using an abdominal incision (laparotomy) or a minimally invasive procedure, i.e. a kind of laparoscopy, can be performed. In addition, depending on the cause, pain therapy, treatment with antibiotics or even therapy to support the circulation is indicated. – an abdominal overview, i.e. an X-ray examination in a standing and left-sided position,

  • The ultrasonic examination (sonography)
  • And also a computed tomography (CT).

A prophylaxis of the acute abdomen is not easily possible. Since there are many possible causes for this, it is theoretically necessary to prevent all of them. But how do you prevent appendicitis?

Perforations with a known preexisting disease, on the other hand, can be avoided by timely therapeutic measures. Gallstones can also possibly be avoided by a balanced diet. A general statement about the prophylaxis of the acute abdomen cannot be made.

The prognosis of the acute abdomen depends on the exact cause. However, it is clear that the acute abdomen is an emergency and that immediate action is required. Depending on the extent and duration of the pre-existing symptoms, the doctor may be fighting for the patient’s life.

A ruptured spleen after an accident is probably more difficult to control than appendicitis. So it is not possible to make a general statement here either.