Dr.C.Ponmudi M.

S
CAUSES OF ‘ACUTE ABDOMEN’

A. Intra – Abdominal Causes

B. Extra – Abdominal causes

A. INTRA-ABDOMINAL CAUSES

1. INFLAMMATION

a. Acute appendicitis.
b. Acute cholecystitis.
c. Acute pancreatitis.
d. Acute colonic diverticulitis.
e. Acute regional ileitis.
f. Acute non-specific mesenteric lymphadenitis.
g. Acute ulcerative colitis.
h. Amoebic liver abscess.
PAIN

1. Time of Onset.

2. Mode of Onset.

3. Site of pain .

4. Shifting of pain.

5. Radiation of pain.

6. Referred pain.

7. Character of pain
Vomiting
1. Vomitus.

2. Its relationship with pain.

3. Bowel habit
2. PERFORATION

a. Peptic perforation.

b. Perforation of a typhoid ulcer.

c. Perforation of ulcerative colitis.

d. perforation of diverticular disease of colon.

3. ACUTE INTESTINAL OBSTRUCTION

(a) Mechanical –
(i) In the lumen – Gallstone, round worms,
feacolith, etc

(ii) In the wall – Tubercular stricture,

intussusception, growths etc.

(iii) Outside the wall – additional bands,

volvulus, external and internal
herniae etc.
 (b) Toxic

Paralytic ileus.

© Neurogenic

Hirschprung’s disease

(d) Vascular

Occlusion of mesenteric vessels by

embolism or thrombosis
e. Volvulus of Sigmoid Colon.

f. Volvulus of the caecum.

g. Meconium ileus.

h. Volvulus of the Mid-gut.

i. Gallstone ileus.

j. Mesenteric vascular obstruction.

k. Intestinal obstruction due to worms.

4. Haemorrhage

e.g. Rupture of ectopic gestation, ruptured

Lutein cyst, spontaneous rupture of malarial spleen.
Rupture or leaking aortic aneurysm, aortic dissecting
aneurysm.

5. Torsion of pedicle

e.g. twisted ovarian cyst, spleen etc.

6. COLICS

a. Biliary Colic.

b. Intestinal Colic.

c. Appendicular Colic.

d. Ureteric Colic
B. EXTRA-ABDOMINAL CAUSES.
1. Parietal Conditions

2. Thoracic Conditions

3. Retro-peritoneal conditions

4. Diseases of the spine, spinal cord and

intercostal nerves

5. General Diseases
In children the following conditions are common:

a. Acute appendicitis;

b. Intussusception;

c. Intestinal obstruction by round worms,

congenital band or by bands including
Meckel’s diverticular;

d. Acute nonspecific mesenteric lymphadenitis;

e. Meckel’s diverticulitis;

f. Primary peritonitis.