What is it about ?
The term “acute abdomen” refers to a group of illnesses that are accompanied by sudden (severe) stomach aches (abdominal pain). We speak of “acute abdomen” when the diagnosis is not yet certain and it is urgent to make a medical decision (such as an intervention). “Acute abdomen” is any form of abdominal pain that lasts less than a week and is not triggered by trauma or injury. Ordinary gastrointestinal inflammation can also lead to sharp abdominal pain. Pain can also be the result of an obstruction of the bile duct, urinary tract or intestine or even a vascular problem (such as abdominal thrombosis). In women with acute abdominal pain, consider the possibility of ectopic pregnancy. It happens that the origin is elsewhere, as in the case of heart attack Where pulmonary embolism, and it is then a pain radiating to the abdomen.
What is its frequency?
Studies show that each year, 56 out of 1,000 people visit their GP with stomach aches (abdominal pain) as their main complaint. In a third of cases, no disease is detected, in another third, abdominal pain has a trivial origin and in the other cases, it is serious to life-threatening conditions that require emergency treatment.
How to recognize it?
Taking into account the large number of possible causes, it is very difficult, here, to specify the origin. In the event of severe abdominal pain, pay attention to the following warning signs and, in these cases, seek medical attention immediately:
- your skin is clammy, you are sweating and you feel dizzy (this may indicate a drop in blood pressure and incipient shock);
- your abdomen becomes hard as a wood, so that you can no longer stick your fingers in it (this indicates peritoneal irritation and always has a serious cause (the peritoneum is the membrane that lines the abdomen));
- you have a high fever (this usually indicates an infection);
- you feel a throbbing mass in your upper abdomen (this may indicate a aneurysm of the aorta; an aneurysm is a balloon-shaped dilation, the aorta can then rupture under pressure, causing massive bleeding)
If you have any of these signs, it’s best to get to your doctor quickly.
How is the diagnosis made?
Your doctor will always start by asking you a series of questions. Often, the answers already make it possible to orient the diagnosis:
- How long have you had symptoms?
- Is this the first time? Do these symptoms occur regularly?
- Do you have any known illnesses such as stomach ulcer ?
- What kind of pain are you feeling?
- Do you have to throw up? If so, are you vomiting brownish, watery food, bile, or vomit (similar to coffee grounds)?
- Do you have fever ?
- Cramps that occur in fits with periods without pain and associated with vomiting may be the result of gallstones, of kidney stones or a intestinal obstruction.
Rather, persistent, sharp, stabbing pain suggests peritoneal irritation.
The intensity of the pain is also important: the stronger the pain, the greater the risk of it being severe. Worsening pain is always suspicious.
The location of the pain may suggest a particular condition: the lower right abdomen area may indicate a appendicitis, pain radiating to the back may indicate a biliary or pancreatic disorder, or stomach ulcer, pain radiating to the groin of kidney stones and pain radiating to the neck irritation of the diaphragm.
Then your doctor will perform a physical examination, paying particular attention to signs of peritoneal irritation: pain when palpating the abdomen (pain on palpation), pain when tapping on the abdomen (pain on percussion ), pain on release (pain when releasing the abdominal wall that was pressed just before), and a hard as a wood abdomen (muscle contracture).
In women of childbearing age, a pregnancy test will always be done.
After questioning the patient and performing a clinical examination, the doctor can make a correct diagnosis in 85-90% of cases. On this basis, he will prescribe additional tests or tell you to go to the hospital urgently.
What can you do ?
If you have sudden, sharp abdominal pain that does not go away on its own, it is best to see your doctor. Be careful with painkillers, as they can temporarily hide symptoms and make the diagnosis more difficult.
What can your doctor do?
It all depends on the cause. The diagnosis is not always easy to make. The doctor must assess whether the situation is urgent. In the presence of warning signs, he will always refer to the emergency department. If he thinks it is not a case of extreme emergency, he may first do a few tests: blood test, urine test, belly ultrasound and possibly a heart exam (a electrocardiogram (ECG)). If, following these examinations, the diagnosis is not yet clear, he will refer you to a specialist.