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Category: Volume 09 Issue 01 January 2021
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Title: Profile of Acute Surgical Abdomen and Their Management –A Prospective Study in a Teaching Hospital

Authors: Dr Anwar Hussain, Dr Nargis Banoo, Dr Sanjay Kumar Bhasin

 DOI: https://dx.doi.org/10.18535/jmscr/v9i1.12

Abstract

Introduction

Acute abdomen is one of the commonest causes of admission in the surgical emergency room, and it encompasses a spectrum of surgical conditions, which requires hospital admission, thorough investigations and prompt treatment in the form of surgical intervention except in few cases, where conservative management is preferred to avoid an unnecessary and difficult surgery (Haworth IE, 1992).

Pain, the most common presenting symptom may be located in any quadrant of the abdomen and its location is a useful starting point that should guide further workup. Similarly, character, nature and intensity of the pain also indicate indirect evidence of underlying cause of acute abdomen. Colicky pain is typically associated with obstructive processes, while pain that is continuous is usually the result of underlying ischemia or peritoneal inflammation (Brewer RJ, Golden GT and Hitch DG, 1976).

The pattern of radiation of pain may provide important clues as to its origin. Pain that involves the entire abdomen almost immediately after onset is usually due to flooding of the peritoneal cavity with an irritating fluid from a perforated ulcer, or from blood and chorionic tissue in a ruptured ectopic pregnancy (Kamin RA, Nowicki TA, Courtney DS, et al., 2003).

The important signs of acute surgical abdomen are the abdominal guarding, rigidity and rebound tenderness. Guarding is a characteristic finding in the physical examination for an abruptly painful abdomen (an acute abdomen) with inflammation of the inner abdominal (peritoneal) surface wherein, the tensed muscles of the abdominal wall automatically go into spasm to keep the tender underlying tissues from being disturbed (Leung AK and Sigalet DL, 2003).

Age differences play a crucial role and are important to be considered when assessing the acute abdomen. As with age not only the incidence of certain pathologies changes but also the clinical presentation varies.

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Corresponding Author

Dr Anwar Hussain

Registrar Department of Surgery, GMC Jammu, India