ACUTE ABDOMEN

An acute abdomen” denotes any sudden, spontaneous, nontraumatic disorder whose chief manifestation is in the abdominal area and for which urgent operation may be necessary. Because there is frequently a progressive underlying intra-abdominal disorder, undue delay in diagnosis and treatment adversely affects outcome.
The approach to a patient with an acute abdomen must be orderly and thorough. The history and physical examination should suggest the probable causes and guide the choice of initial diagnostic studies. The clinician must then decide if in-hospital observation is warranted, if additional tests are needed, if early operation is indicated, or if nonoperative treatment would be more suitable.All clinicians should be thoroughly familiar with the presenting pattern of the following most common causes of an acute abdomen.
a-Gastrointestinal tract disorders
Nonspecific abdominal pain, Acute appendicitis, Small and large bowel obstruction, Perforated peptic ulcer ,Incarcerated hernia, Bowel perforation, Inflammatory bowel disorders, Mallory weiss syndrome, Bowel perforation Mickel;s diverticulitis, Diverticulitis
b-Liver, spleen and biliary tract disorders: Acute cholecystitis, Acute cholangitis, Hepatic abscess, Ruptured hepatic tumour ,Splenic rupture, Splenic infarct ,Biliary colic, Acute hepatitis
c- Pancreatic disorders: acute Pancreatitis
d-Peritoneal disorders:Intra-abdominal abscesses, Primary peritonitis, Tuberculous peritonitis
e-Urinary tract disorders: Ureteral or renal colic, Acute pyelonephritis, Acute cystitis, Renal infarct

f-Vascular disorders; Ruptured aortic and visceral aneurysms, Acute ischemic colitis, Mesenteric thrombosis
g-Gynecological disorders:Ruptured ectopic pregnancy, Twisted ovarian tumour, Ruptured ovarian follicle cyst, Acute salpingitis, Dysmenorrheal disorder, endometriosis
HISTORY
Abdominal Pain Pain is the most common and predominant presenting feature of an acute abdomen. Careful consideration of the location, the mode of onset and progression, and the character of the pain will suggest a preliminary list of differential diagnoses.