Managing an acute abdomen

Abstract 

The acute abdomen is often a diagnostic challenge, particularly in the young child. An initial assessment of vital signs and fluid resuscitation are pivotal in management, whatever the cause. Careful attention to fluid maintenance, and assessment and replacement of ongoing losses optimize operative intervention if required and preserve haemodynamic stability. Laboratory and radiological tests are useful adjuncts, but history taking, careful examination and re-examination are the mainstays in decision making. A useful scheme for classifying acute abdominal conditions is to consider whether they result from irritation of the peritoneum or obstruction (although these may coexist), arising de novo or as a result of trauma.

Keywords: peritonitis, intestinal obstruction, abdominal trauma, bile-stained vomiting, acute abdomen

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• f1 Correspondence to: AW. E-mail: alunrwilliams@yahoo.co.uk