If a person has suffered a sharp pain in the abdomen, and the abdominal wall has become strained, immediately call an ambulance so that specialists can examine the patient and make the necessary steps in time.
The concept of
The diagnosis of an acute abdomen is a temporary indication combining a number of diseases that have similar underlying symptoms.
The diagnosis of an acute abdomen is designated R10.0 in accordance with the classification of diseases of the international format( ICD-10).
Causes of
Acute condition occurs due to the development in the patient's body of such diseases:
- ruptures of internal organs when bleeding occurs in the abdominal cavity:
- of the uterus( including appendages),
- of the liver,
- of the pancreas,
- of the spleen;
- Intestinal obstruction,
- acute diseases:
- pancreatitis,
- appendicitis,
- cholecystitis;
- hollow organ integrity disorder( perforation or rupture):
- intestine,
- stomach;
Symptoms of an acute abdomen
Signs of a group of diseases that are attributed to the concept of an acute abdomen are:
- Stool disorder. The patient may experience constipation, which is triggered by a deterioration in the dynamics of the intestine, up to the intestinal obstruction. Sometimes the stool changes toward a very liquid consistency.
- In stool can be observed impurities of blood.
- Very characteristic symptoms include acute pain in the abdomen.
- There are cases of continuous hiccups for a long time, this phenomenon initiates an irritated nerve located in the diaphragm.
- Acute condition may be accompanied by nausea and vomiting.
- There are cases when among the symptoms there is one that in the horizontal state begins acute pain, and if the patient sits down, then she lets( a symptom of "vanka-vstanka").
- If there is a discharge into the peritoneum of exudate, blood or contents of the gastrointestinal tract, this will cause irritation of the diaphragmatic nerve, which in turn initiates soreness with pressing between the legs of the sternocleidomastoid muscle. This phenomenon is called a "frenicus-symptom".
- Among the very characteristic symptoms experts note the tension of the abdominal muscles. It can be exactly above the pain point or grab a large area of the transverse muscle. Muscle tension happens as a protective reaction of the body to severe pain. This sign becomes not very noticeable in persons with the abdominal wall of a flabby species, stretched, for example, by birth or due to age.
Video about what are the symptoms of an acute abdomen in surgery:
False sharp stomach
Signs of an acute abdomen do not always show a reliable presence of such a diagnosis. Therefore, the ability to quickly understand the situation, to make diagnostic measures to exclude the presence of pseudoabdominal syndrome is required.
False acute abdomen can be provoked:
- colitis,
- acute pneumonia,
- gastritis,
- pyelonephritis,
- myocardial infarction.
In children
In childhood, the acute abdomen often provokes acute appendicitis. The condition is accompanied by symptoms:
- loose stool( with mucus),
- child lethargy,
- sleep disorder,
- the child is prone to be whimsical.
But the tension of the abdominal wall, characteristic of this diagnosis in adulthood, may not be expressed or even absent.
In gynecology
Diagnosis of an acute abdomen from the gynecology cause such pathologies:
- dysmenorrhea,
- salpingitis,
- in the middle of the menstruation cycle the appearance of severe abdominal pain.
Diseases by the nature of the flow are divided into three groups:
- genitals are in an acute inflammatory process, which affects the peritoneum;
- bleeds into the cavity caused by:
- ovarian apoplexy,
- ectopic pregnancy;
- in organs belonging to the gynecological sphere, there are pathologies initiated by circulatory disorders:
- necrosis or torsion of the myomatous node,
- torsion of formation( tumor) on the ovary.
In acute conditions associated with the disease of the organs of childbearing, there are such symptoms:
- nausea and, possibly, vomiting;
- peritoneal strain,
- malfunction associated with bowel movement, fecal texture disturbance.
When pregnancy
The condition of an acute abdomen associated with pregnancy can occur with the pathology of the process, namely, an ectopic pregnancy. When the ectopic fetus breaks the tube, and the blood and elements of the fetal egg enter the abdominal cavity, all the prerequisites of the acute abdomen are created.
This pathology is one of the frequent reasons that initiates the clinical picture of the disease examined in this article.
How to identify the disease?
The specialist has little time to give an opinion of what the cause of the patient's ailment is. Is going to anamnesis of the disease. Attention:
- symptoms of the condition,
- skin color,
- posture, which the patient takes.
A more complete picture can show an ultrasound examination of internal organs. In addition, the following studies will be informative for such a case:
- X-ray review using contrast medium,
- if necessary - mesentericography;the study involves the introduction of a contrast agent in the mesenteric artery;
- celiacography - examination of the condition of the celiac trunk,
- if the picture remains unclear, laparoscopy may be used( for diagnostic purposes).
Laboratory tests of urine and blood clear:
- is there an inflammatory process,
- is there anemia.
Differential diagnosis
There are several methods of diagnosing an acute abdomen that do not require special equipment, but are sufficiently informational methods. These methods include:
- rectal examination - a specialist pays attention to the reaction of a person when pressing a finger on the wall of the rectum;This method allows you to find out whether there is effusion in the small pelvis;
- palpation of the abdominal region - the method makes it possible to assume:
- source of pain,
- to understand the localization of peritoneal tension, the degree of its irritation;
- listening to the stomach is done to determine what degree of gassing the stomach is;intestinal noises give information about the processes inside the abdomen( if there is complete obstruction, then noises are not audible);
- percussion provides information of this kind:
- is there effusion,
- is there gas and its localization in the abdomen,
- is the change in the boundaries of the liver.
Treatment and delivery of the first emergency medical aid
Before establishing the causes of acute condition, one can not independently try to ease the person's well-being:
- to give anesthetic,
- to do enemas,
- to offer food.
When determining an acute abdomen, as a rule, the patient is urgently operated.
Forecast
Conditions associated with symptoms of an acute abdomen, carry the preconditions of a life threat.
It is believed that before surgery from the time of the onset of an acute condition, it is desirable that at least six hours have elapsed. If the surgery did not happen on time, the outlook is encouraging.