acute abdomen
  Is an emergency surgical condition caused by damage to one or more abdominal organs following injury or disease. The patient is in severe pain and often in shock. Perforation of a peptic ulcer or a severely infected appendix, or rupture of the liver or spleen following a crushing injury, all produce an acute abdomen requiring urgent treatment.
an abnormal condition characterized by the acute onset of severe pain within the abdominal cavity. An acute abdomen requires immediate evaluation and diagnosis because it may indicate a condition that calls for surgical intervention. Information about the onset, duration, character, location, and symptoms associated with the pain is critical in making an accurate diagnosis. The patient is asked what decreases or increases the pain; constant, increasing pain is generally associated with appendicitis and diverticulitis, whereas intermittent pain more likely indicates an intestinal obstruction, ureteral calculi, or biliary calculi. Appendicitis may often be differentiated from a perforating ulcer by the slower onset or development of pain. Although the patient's report of the location of the pain is sometimes misleading because of referral, radiation, or reflection of pain, it may serve to identify a specific organ or system. Factors in the patient's history that are useful in the diagnosis and management of an acute abdomen include changes in bowel habits, weight loss, bloody stool, diarrhea, menses, vomiting, clay-colored stool, and previous abdominal surgery.
A relatively nonspecific symptom complex, in which a Pt is first seen in a 'toxic' state, complaining of incapacitating abdominal pain, variably accompanied by fever, and leukocytosis; AA may also be defined as an acute intra-abdominal inflammatory process that may require surgical intervention; appendicitis is the most common cause of an AA; nearly 100 other conditions may present in a similar fashion, in particular, ruptured ectopic pregnancy in a fallopian tube, ruptured acute diverticulitis and acute mesenteric lymphadenitis.
 

 ACUTE ABDOMEN ETIOLOGY

Infection
Amebiasis, hepatitis, falciparum malaria, pneumococcal pneumonia, rheumatic fever, salmonella gastroenteritis, staphylococcal toxemia, syphilis in 'tabetic crisis,' trichinosis, TB, typhoid fever, viral enteritides, herpes zoster, infectious mononucleosis, Whipple's disease
Inflammation
Appendicitis, cholangitis, cholecystitis, Crohn's disease, diverticulitis, gastroenteritis, hepatitis, SLE, mesenteric lymphadenitis, pancreatitis, peritonitis due to organ perforation, perinephric abscesses, pyelonephritis, ulcerative colitis, intestinal obstruction, rheumatoid arthritis, polyarteritis nodosa, Henoch-Schönlein disease
Intoxication
Black widow spider bite, heavy metals, mushrooms
Ischemia
Renal infarction, mesenteric arterial thrombosis
Malignancy
Pain due to organ infarction, Hodgkin's disease ('classically' associated with alcohol ingestion), leukemia, lymphoproliferative disorders
Metabolic disease
Adrenal insufficiency (Addisonian crisis), DKA, familial hyperlipoproteinemia, familial Mediterranean fever, hemochromatosis, hereditary angioneurotic edema, hyperparathyroidism, hyperthyroidism, acute intermittent porphyria, uremia, substance abuse withdrawal
Ob/Gyn
Twisted ovarian cyst, ectopic pregnancy, endometriosis, PD
Referred pain
Pneumonia, MI, pleuritis, pericarditis, myocarditis, hematomata of the rectal muscle, renal colic, peptic ulcer, nerve root compression
Trauma
Perforation/rupture–aortic aneurysm, spleen, bladder.

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