Acute abdomen - refers to a recent, rapid onset of urgent abdominal or pelvic pathology, usually presenting with abdominal pain. This is a common presentation and has a wide variety of causes.
Causes of acute abdominal pain
Initial assessment
Investigations
Bedside:
- In any woman of child-bearing age presenting with abdominal pain, an ectopic pregnancy must be ruled out urgently with a 'bedside' urine dip.
Labs:
- FBC - gives an indication of bleeding (drop in Hb) and infection / inflammation (raised WBC).
- U&E - give an indication of electrolyte imbalance and kidney function (useful prior to CT scans, as they require a contrast injection that can damage kidneys).
- LFT - give an indication of the state of the biliary and hepatic system.
- CRP - Inflammatory marker
- Amylase - gives an indication of inflammation of the pancreas in acute pancreatitis.
- Urea - raised level indicates upper GI bleed
- INR - gives an indication of the synthetic function of the liver and is essential in establishing their coagulation prior to procedures.
- Calcium - required to score acute pancreatitis and for other reasons (e.g., clotting and cardiac function).
- ABG - analysis will show the lactate (an indication of tissue ischaemia) and pO2 (used for scoring in acute pancreatitis). Lactate is a product of anaerobic respiration and can also be raised in dehydration or hypoxia.
- Blood cultures - ?infection