Acute Abdominal Pain
Acute Abdominal Pain
Acute abdominal pain is one of the most common reasons for emergency consultations. It is defined as a sudden and severe pain in the abdomen, accompanied by serious abdominal symptoms that require urgent medical or surgical treatment. It is a symptom that can have multiple causes, both surgical and non-surgical, and requires careful evaluation to identify the underlying etiology and determine the appropriate treatment.
Surgical Pathologies Causing Acute Abdominal Pain
Some of the most common surgical causes include:
Acute appendicitis: inflammation of the appendix, which can lead to perforation if untreated.
Acute cholecystitis: inflammation of the gallbladder, usually caused by gallstones.
Diverticulitis: inflammation of diverticula in the colon, which can be complicated by abscesses or perforation.
Intestinal obstruction: can be caused by adhesions, hernias, or tumors, leading to pain due to the accumulation of gas and fluids.
Peritonitis: inflammation of the peritoneum, often as a result of a perforated organ.
Mesenteric ischemia: reduced blood flow to the intestines, which can lead to bowel necrosis.
These conditions usually require urgent surgical intervention to prevent serious complications and, in some cases, death.
Non-Surgical Pathologies Causing Acute Abdominal Pain
Non-surgical causes of acute abdominal pain may include:
Gastroenteritis: infection of the gastrointestinal tract causing abdominal pain, diarrhea, and vomiting.
Renal colic: intense pain due to the passage of kidney stones through the ureters.
Acute pancreatitis: inflammation of the pancreas, often associated with alcohol consumption or gallstones.
Inflammatory bowel disease: such as Crohn's disease or ulcerative colitis, which cause chronic inflammation of the intestines.
Peptic ulcer: can perforate or bleed, causing acute pain.
Diagnostic Tests
To achieve an accurate diagnosis of acute abdominal pain, it is essential to conduct a thorough medical history and a complete physical examination, both abdominal and extra-abdominal. Subsequently, to confirm the likely diagnosis, a series of tests is requested.
Blood tests: include a complete blood count to detect signs of infection or inflammation (leukocytosis), and tests for liver and kidney function. Amylase and lipase levels are helpful in detecting pancreatitis.
Urine analysis: helps rule out urinary tract infections or the presence of hematuria in cases of renal colic.
Imaging tests: such as abdominal ultrasound and computed tomography (CT) are crucial for visualizing internal structures. Ultrasound is useful for assessing the gallbladder and kidneys, while CT is more accurate in diagnosing appendicitis, bowel obstructions, and perforations.
Role of the Surgeon in Treatment
The surgeon plays a fundamental role in the evaluation and treatment of acute abdominal pain. When a surgical cause is suspected, such as appendicitis or cholecystitis, early intervention is crucial to prevent complications. In cases like bowel obstruction or organ perforation, surgery is urgent. However, it is important to note that symptoms are not always typical, and the clinical presentation can vary. Therefore, an experienced physician's evaluation is essential to determine if the patient requires surgical intervention or medical treatment.