The term “acute abdomen” is a prefabricated symptom complex that characterizes sudden acute diseases of the abdominal cavity or its mechanical damage, in which emergency medical intervention is most often required. Usually, the first assessment of the condition of a patient with an acute abdomen is given by doctors already at the first examination and history. Correct differential diagnosis (the most probable diagnosis is important here, since transportation to a medical institution and additional diagnostic procedures will be necessary for an accurate determination) and prompt assistance.
A feature of the acute abdomen is that the patient's condition worsens with each passing hour. Acute abdominal pains are only evidence of the beginning of the pathological process, and even if they subside for a while, this does not mean that the situation has improved.
A similar condition in a patient may occur due to the following reasons:
- mechanical damage to the abdominal cavity;
- inflammatory course of pathological processes in the abdominal cavity (for example, peritonitis);
- violation of the integrity of the hollow organ;
- intestinal obstruction ;
- problems with venous and arterial circulation in the peritoneum;
- hemorrhage in the abdominal cavity;
- pathological processes in the female reproductive system (ovarian rupture, ectopic pregnancy, ovarian cyst, etc.).
Symptoms of an acute abdomen are quite obvious, patients do not miss them, since painful sensations, as a rule, are very strong, cannot be relieved by analgesics, are forced to take a forced position, or vice versa, often change it (depends on the mental perception of the situation), paralyze performance. Patients are in a state of pain shock.
When examining a patient with a symptom of "acute abdomen", it is important to pay attention to such signs: the patient’s position, the adequacy of the psyche, the presence of dehydration, the color of the skin, the frequency and quality of the stool. After a general examination, it is necessary to measure the temperature (in the axillary region and rectally), to determine hemodynamic parameters. Next, the stomach is examined - it is tapped and listened, noises are determined, the volume of the abdomen (swollen, sunken) is established, the rectum is examined for the presence of edema, overhanging walls, bleeding. If all the signs indicate an “acute abdomen”, then the patient must be urgently taken to a medical institution to clarify the diagnosis - whether it is a perforation of an organ, or blockage, or intra-abdominal bleeding. Analgesics should not be given before hospitalization - they can erase the symptomatic picture and lead to incorrect diagnosis.
If during the hospitalization or even before the doctor’s call, the patient has a pain shock, then it is necessary to take measures to remove him from this state.
Upon arrival at the medical institution , a study of the cardiovascular system is carried out to determine the shock index in case of possible bleeding (determines the percentage loss of blood). An x-ray and ultrasound are also done.
If the "acute abdomen" is diagnosed in women, it is necessary to pay attention to a possible pregnancy, the date of the last menstruation, the presence of an intrauterine device, the presence of concomitant gynecological diseases.
Upon receipt of a reliable picture of the pathology inside the peritoneum, a diagnostic laparoscopy is done - examination through a small incision that reveals a diseased organ or other problems. Usually, immediately after laparoscopy, a wider incision is made to access, the abdominal cavity is washed , the cause of the disease is eliminated. At the same time, if necessary, the patient is given a blood transfusion, glucose is administered to maintain the condition.
With timely access to a medical institution, a quick and correct diagnosis, most patients save lives.