Acute Abdomen

(Acute Abdominal Pain; Severe Stomach Ache; Abdominal Cramps; Surgical Abdomen)

Definition

“Acute abdomen” is the medical term used for pain in the abdomen that usually comes on suddenly and is so severe that one may have to go to the hospital. As opposed to common abdominal pain, which can be caused by minor issues such as constipation or gas, acute abdominal pain can signal a variety of more serious conditions, some of which require immediate medical care and/or surgery. Therefore, if you suspect you have this condition, contact your doctor immediately.

Abdominal Organs, Anterior View

Causes

There are a number of possible causes of acute abdomen. These include:

Viral gastroenteritis —stomach flu
Intestinal obstruction
Hernia
Appendicitis —inflammation of the appendix
Pancreatitis —inflammation of the pancreas
Diverticulitis —inflammation of small pouches that form in the large intestine
Cholecystitis—inflammation of the gallbladder, with or without gallstones
Cholangitis—inflammation of the bile duct caused by a gallstone or a bacterial infection
Gastritis —inflammation of the stomach lining, such as from drinking too much alcohol or prolonged use of nonsteroidal anti-inflammatory drugs (NSAIDs)
Kidney, bladder, or urinary tract infection
Kidney stones
Ulcerative colitis or Crohn’s disease —inflammatory diseases of the intestines
Sickle cell crisis
Diabetic ketoacidosis—dangerously high levels of acids in the blood
Ruptured or leaking abdominal aortic aneurysm —abnormally large blood vessels in the abdomen
Ischemia—inadequate, or blocked, blood supply to one of the abdominal organs
Infectious diarrhea
Irritable bowel syndrome (IBS)
Heartburn or gastroesophageal reflux disease (GERD)
Peptic ulcer
Heart attack
Cancer
Pneumonia
In women:
- Menstrual cramps
- Endometriosis
- Uterine fibroids
- Ovarian cysts
- Pelvic inflammatory disease —inflammation around the ovaries, uterus, and fallopian tubes
- Miscarriage or ectopic pregnancy
In infants:
- Intussusception (the telescoping of one portion of the intestine into another, causing obstruction of the bowel and blockage of its blood flow)
- Volvulus—a twisting of the colon around itself
- Hirschsprung's disease —also known as congenital megacolon
- Other congenital defects of the digestive tract

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition. Risk factors for acute abdomen include the following:

Infancy or childhood
Increased age

Symptoms

The symptoms of acute abdomen have a variety of causes. If you experience any one of them, see your physician.

Persistent, severe pain, swelling, and/or tenderness in the upper, middle, or lower abdomen
Guarding—involuntary contraction of the abdominal muscles
Rigidity—when abdominal muscles are tense and board-like
Fever

Diagnosis

Your doctor will ask you for details about your pain, such as the exact location and duration, and about any additional symptoms you may be experiencing, such as bowel or urinary symptoms. He or she will also take your medical history, including any drugs or medications you’ve taken, and perform a physical exam, including rectal and pelvic examinations.

Additionally, one or more of the following tests may be necessary to make a diagnosis:

Blood tests
Urine analysis
Liver function tests
Ultrasound —a test that uses sound waves to examine the abdomen
CT scan —a type of x-ray that uses a computer to make pictures of structures inside the abdomen
MRI scan —a test that uses magnetic waves to make pictures of structures inside the abdomen
KUB (kidney, ureter, and bladder) x-rays
Barium x-rays
Angiography
Surgery
Endoscopy—a thin, lighted tube inserted down the throat to examine the abdominal area

Treatment

For symptom relief, mild analgesics may be prescribed to reduce pain, however many doctors forgo prescribing painkillers since details of the pain can be useful in determining its cause. Do not take any medication such as Tylenol or ibuprofen, and do not eat or drink until you have spoken with your doctor.

Talk with your doctor about the best treatment plan for you. Depending on the underlying condition causing your acute abdomen, treatment options may include:

Antibiotics
Avoidance of certain foods, beverages, or medicines
Surgery—may be required for the majority of severe abdominal pains that last for at least six hours in previously healthy patients

Prevention

Depending on the underlying condition causing acute abdomen, prevention measures will vary. Talk with your doctor about preventing conditions that cause acute abdomen.

RESOURCES

American Academy of Family Physicians http://familydoctor.org/527.xml

National Digestive Diseases Information Clearinghouse (NDDIC) http://digestive.niddk.nih.gov/index.htm

CANADIAN RESOURCES

Canadian Association of Gastroenterology (CAG) http://www.cag-acg.org/

Canadian Digestive Health Foundation http://www.cdhf.ca/index.html

References

Abdominal pain, short-term. American Academy of Family Physicians website. Available at: http://familydoctor.org/527.xml. Accessed November 18, 2006.

Acute abdomen and surgical gastroenterology. The Merck Manuals Online Medical Library website. Available at http://www.merck.com/mmpe/sec02/ch011/ch011b.html . Accessed November 30, 2006.

Acute abdominal pain in children. American Academy of Family Physicians website. Available at: http://www.aafp.org/afp/20030601/2321.html . Accessed November 24, 2006.

Digestive diseases A-Z list. The National Digestive Diseases Information Clearinghouse (NDDIC) website. Available at http://digestive.niddk.nih.gov/ddiseases/a-z.asp. Accessed November 24, 2006.

Oxford Reference: Concise Medical Dictionary . 3rd ed. Oxford University Press: Market House Books; 1990.

Zeller JL. Acute abdominal pain. JAMA . 296(14):1800. Available at: http://jama.ama-assn.org/cgi/content/full/296/14/1800 . Accessed November 19, 2006.

Revision Information

Reviewer: Daus Mahnke, MD
Review Date: 10/2012
Update Date: 10/31/2012

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.