any sudden, severe abdominal pain of multiple etiology that is less than 24 hours in duration.

It is in many cases a medical emergency, requiring urgent and specific diagnosis.

Causes
Few causes that may cause acute abdomen :
Inflammatory io!agents or chemical reactions "echanical #bstructive conditions $eoplastic %asculary &hrombosis or embolism &rauma 'harp or dull traumatic causes

(ifferential (iagnosis
&he differential diagnoses of acute abdomen include but are not limited to: )cute appendicitis. )cute peptic ulcer and its complications. )cute cholecystitis. )cute pancreatitis. )cute intestinal ischemia. (iabetic *etoacidosis. )cute (iverticulitis. +ctopic ,regnancy with tubal rupture. )cute peritonitis. owel perforation with free air or bowel contents in the abdominal cavity. owel volvulus. )cute ureteral colic. )cute pyelonephritis. -atroto.in /-atrodectus /blac0 widow spider1.

,eritonitis
an inflammation of the peritoneum, the serous membrane that lines part of the abdominal cavity and viscera. ,eritonitis may be localised or generalised, and may result from infection or from a non!infectious process.

"anifestations
(iffuse abdominal rigidity Fever 'inus tachycardia (evelopment of paralytic ileus which may also causes nausea and vomiting

)ppendicitis
inflammation of the appendi..

,athophysiology
,rimary obstruction of the appendi. lumen. &he appendi. subsequently becomes filled with mucus and swells, resulting inflammation. )s it progresses, the appendi. becomes ischemic and then necrotic. acteria begin to lea0 out through the dying walls, ,us formed within and around the appendi. /suppuration1. 2esult an appendiceal rupture /a 3burst appendi.31 causing peritonitis, therefore, abdominal pain.

'igns and 'ymptoms

)bdominal pain at the umbilical region /early stage1 )nore.ia $ausea %omiting Fever &he pain then settles into the 2-4 where tenderness develops.

+.ams and &ests

5'6 C C / usually neutrophilic leucocytosis 1 C& 'can

,hysical +.ams
Guarding. 6uarding occurs when a person subconsciously tenses the abdominal muscles during an e.amination. %oluntary guarding occurs the moment the doctor7s hand touches the abdomen. Involuntary guarding occurs before the doctor actually ma0es contact. Rebound tenderness. ) doctor tests for rebound tenderness by applying hand pressure to a patient7s abdomen and then letting go. ,ain felt upon the release of the pressure indicates rebound tenderness. ) person may also e.perience rebound tenderness as pain when the abdomen is 8arred9for e.ample, when a person bumps into something or goes over a bump in a car. Rovsings sign. ) doctor tests for 2ovsing7s sign by applying hand pressure to the lower left side of the abdomen. ,ain felt on the lower right side of the abdomen upon the release of pressure on the left side indicates the presence of 2ovsing7s sign. Psoas sign. &he right psoas muscle runs over the pelvis near the appendi.. Fle.ing this muscle will cause abdominal pain if the appendi. is inflamed. ) doctor can chec0 for the psoas sign by applying resistance to the right 0nee as the patient tries to lift the right thigh while lying down. Obturator sign. &he right obturator muscle also runs near the appendi.. ) doctor tests for the obturator sign by as0ing the patient to lie down with the right leg bent at the 0nee. "oving the bent 0nee left and right requires fle.ing the obturator muscle and will cause abdominal pain if the appendi. is inflamed.

)lvarado 'core

) score below : is strongly against a diagnosis of appendicitis, while a score of ; or more is strongly predictive of acute appendicitis.

(ifferential (iagnosis
In children: 6astroenteritis, mesenteric adenitis, "ec0el3s diverticulitis, intussusception, <enoch!'ch=nlein purpura, lobar pneumonia, urinary tract infection /abdominal pain in the absence of other symptoms can occur in children with 5&I1, new!onset Crohn3s disease or ulcerative colitis, pancreatitis, and abdominal trauma from child abuse> distal intestinal obstruction syndrome in children with cystic fibrosis> typhlitis in children with leu0emia> in girls: menarche, dysmenorrhea, severe menstrual cramps, "ittelschmer?, pelvic inflammatory disease,ectopic pregnancy In adults: regional enteritis, renal colic, perforated peptic ulcer, pancreatitis, rectus sheath hematoma> in men: testicular torsion, new!onset Crohn3s disease or ulcerative colitis> in women:pelvic inflammatory disease, ectopic pregnancy, endometriosis, torsion@rupture of ovarian cyst, "ittelschmer? /the passing of an egg in the ovaries appro.imately two wee0s before an e.pected menstruation cycle1 In elderly: diverticulitis, intestinal obstruction, colonic carcinoma, mesenteric ischemia, lea0ing aortic aneurysm.

&reatment
'urgical treatment I% A )ntibiotics

,rognosis
"ost appendicitis patients recover easily with surgical treatment, but complications can occur if treatment is delayed or if peritonitis occurs. 2ecovery time depends on age, condition, complications, and other circumstances, including the amount of alcohol consumption, but usually is between BC and 2D days. For young children /around BC years old1, the recovery ta0es three wee0s.

Ileus
Ileus is a disruption of the normal propulsive gastrointestinal motor activity due to non!mechanical causes. In contrast, motility disorders that result from structural abnormalities are termed mechanical bowel obstruction.

Classification
Postoperative Ileus It is a temporary paralysis of a portion of the intestines typically after an abdominal surgery. Paralytic Ileus ,aralysis of the intestine. ,aralytic ileus is a common side effect of some types of surgery. It can also result from certain drugs and from various in8uries and illnesses.

'igns and 'ymptoms

moderate, diffuse abdominal discomfort constipation abdominal distension nausea@vomiting, especially after meals lac0 of bowel movement and@or flatulence e.cessive belching

(iverticulitis
swelling /inflammation1 of an abnormal pouch /diverticulum1 in the intestinal wall. &hese pouches are usually found in the large intestine /colon1. &he presence of the pouches themselves is called diverticulosis.

,athophysiology
'mall, protruding sacs of the inner lining of the intestine /diverticulosis1 can develop in any part of the intestine. &hey are most common in the colon, especially the sigmoid colon, the lowest part of the colon. &hese sacs, called diverticula, occur more often after the age of 4C. Ehen they become inflamed, the condition is 0nown as diverticulitis. (iverticula are thought to develop as a result of high pressure or abnormal pressure in the colon. <igh pressure against the colon wall causes pouches of the intestinal lining to bulge outward through small defects in the colon wall that surround blood vessels. (iverticulitis is caused by inflammation, or /sometimes1 a small tear in a diverticulum. If the tear is large, stool in the colon can spill into the abdominal cavity, causing an infection /abscess1 or inflammation in the abdomen.

 )bdominal pain, usually in the left lower abdomen but can be anywhere Fever $ausea %omiting Eeight loss

+.ams and &ests

)bdominal palpation C& scan

&reatment
!)cute diverticulitis is treated with antibiotics. !&he involved portion of the colon may need to be removed with surgery if you have: )bscess <ole /perforation1 in the colon Fistula /abnormal connections between different parts of the colon or the colon and another body area1 2epeated attac0s of diverticulitis !)fter the acute infection has improved, eating high!fiber foods and using bul0 additives such as psyllium may help reduce the ris0 of diverticulitis or other symptoms.

Complications
)bscess formation $arrowing /stricture1 in the colon or fistula formation ,erforation of the colon leading to peritonitis