Acute abdominal pain (acute Abdomen)

Strong and sudden abdominal pain

Acute and severe abdominal pain as an emergency: the term acute Abdomen or acute abdomen to collect various abdominal diseases in which suddenly, a life-threatening condition can occur. Accompanies the acute Abdomen of the most violent, strong abdominal pain, colic occur fast or permanently. Often, the severe pain associated with Nausea and vomiting. A palpable hard abdominal wall (muscular tenderness), as well as a bloated belly in the case of absolute Lack of bowel movements or outgoing winds often occur. There is an urgent emergency exists, if the ongoing abdominal pain from the vomiting of Blood, fever, tachycardia (rapid heartbeat), low blood pressure, facial pallor and cold sweat. Then shock and circulatory failure, requiring intensive medical treatment.

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Acute abdomen: A brief Overview

Sudden and violent pain in the abdomen occur, the shear-like manner or continuously stronger, this is often a sign of a medical emergency. For these complaints serious and life-threatening diseases can be responsible, especially if the pain is accompanied by other symptoms. In case of doubt, should not wait, but immediately an ambulance will be called. Here is a brief Overview of the symptoms:

  • Synonyms: Acute abdomen surgical abdomen surgical Abdomen, acute abdomen, acute abdominal pain, acute Abdomen, severe abdominal pain.
  • Symptoms: Sudden and intense abdominal pain, Nausea, vomiting, severe abdominal, bloating.
  • Emergency: Deterioration of the condition continually, and appear to the pain symptoms, such as hematemesis, tachycardia, blood pressure drop, pallor, dizziness, cold sweat, shock and difficulty breathing, should be immediately an ambulance called.
  • Possible causes: stomach-intestine infection, as well as some other infectious diseases, intestinal obstruction, peritonitis, peptic ulcer disease, biliary colic, cholecystitis, gallbladder perforation, inflammation of the pancreas bladder, small intestine, colon, or cecum inflammation, internal injuries, broken abdominal aorta, occlusion of an abdominal artery, heart attack.

What to do in case of an emergency?

Sudden onset of acute and severe discomfort in the abdominal area are often a sign of an emergency. How the German Red cross reported, should be Helping and the Affected behavior is as follows, if such an emergency occurs:

  • The rescue service number 112 to alert.
  • The patient should be reassured and cared for until the ambulance arrives.
  • Restlessness and hustle and bustle should be avoided.
  • The patient should be covered warm.
  • Often, Sufferers adopt a relieving posture, with her knees pulled up. This attitude can be supported by pillows or a Knee between the legs.
  • Breathing difficulties occur, should be stored in the torso increases.
  • Affected allowed to eat or drink, there’s an upcoming emergency surgery is likely to be.
  • Likewise, no medication should be administered. This can complicate the diagnosis.

Causes of acute abdominal pain

There are a variety of diseases is out of the question, on the bottom of an acute Abdomen may occur. The professional Association of German internists cites the following diseases as a common cause for an acute Abdomen:

  • Inflammation of the gallbladder,
  • Appendicitis,
  • Inflammation of the gut wall protrusions (diverticulitis),
  • massive disruption and the closure of intestinal transit (Ileus),
  • acute inflammation of the pancreas (pancreatitis),
  • Breakthrough of a stomach or duodenal ulcer,
  • of acute closure of a bowel vessel (mesenteric infarction),
  • pinched ureter stones, or gallstones,
  • a trapped hernia,
  • Colon cancer,
  • Adhesions in the connective tissue,
  • Protuberance of a blood vessel (aortic aneurysm) with hemorrhage into the vessel wall,
  • special forms of myocardial infarction (posterior wall infarction),
  • Inflammation of the lungs,
  • Inflammation of the rib head,
  • gynecological diseases,
  • Testicular torsion,
  • derailed Diabetes,
  • Kidney Failure (Uremia),
  • internal injuries in the abdominal area.

Diseases of the digestive organs

From the area of the digestive organs, especially an intestinal obstruction (Ileus) and a peritoneal inflammation (Peritonitis), as well as the peptic ulcer disease with bleeding or breakthrough of the ulcers are to be mentioned. Furthermore, the biliary colic will find the cause, an acute inflammation of the gallbladder and biliary perforation (penetration of the gall bladder), but also an acute inflammation of the pancreas, the stomach is accompanied by all the most with (some cramping) pain in the upper right. Intestinal inflammations such as Ileitis and colitis, and acute appendicitis (appendicitis) often with pain in the umbilical region, during the acute diverticulitis of the colon typically causes pain in the left lower abdomen.

Liver or spleen as a cause

Acute liver disease can cause sudden and severe abdominal pain. The causes of this congestion, inflammation, Abscess or a rupture of the liver. Similarly, an acute spleen disease may be the cause of an acute Abdomen. A splenic infarction, abscess, or a ruptured spleen can cause the above symptoms. In the case of a ruptured spleen it can lead to life-threatening internal bleeding. In rare cases, a rupture of the spleen can occur as a complication of Pfeiffer’s glandular fever.

Infectious diseases

Similarly, complicated histories of infectious diseases can lead to acute Abdomen, for example, Malaria, TB, typhoid, or virus hepatitis. The abdominal diffuse pain here felt in the umbilical region, and are described as dull, boring or spasmodic.


Blow, shock, or impact, injuries in the abdominal region, can hurt organs, and to crack about a spleen or a ruptured Liver. Pain according to the organ position in the case of spleen rupture in the left, in the case of liver rupture, especially in the right upper abdomen noticeably.

Blood vessels

A geplatzes aortic aneurysm of the abdominal aorta leads to severe abdominal pain, often accompanied by shoulder pain and back pain. Just like a mesenteric infarction, which can occur as a result of closure of an abdominal artery is suddenly and with the most violent pain symptom-free intervals, with diffuse abdominal pain alternate.

Causes outside of the abdominal cavity

A heart attack can occur if the abdominal pain below the navel area. A Pericarditis, or pulmonary diseases such as pneumonia and lung pleura inflammation are often accompanied by fever and breathing-dependent pain.

Diabetes as a cause

Derailed Sugar levels in Diabetes mellitus can lead to an absolute insulin deficiency. This condition is medically referred to as ketoacidosis. Also acute abdominal pain and other nonspecific symptoms, such as difficulty in breathing, Nausea and vomiting, frequent urination, thirst and weakness occur. The ketoacidosis must be treated right away, since the condition ends otherwise be fatal.

Metabolic disorders

A strong fat metabolism disorder can lead to an extreme increase of triglyceride levels in the blood. This can lead to inflammation of the pancreas, which manifests itself pain in turn, by strong acute abdominal. Furthermore, a massive shield can glands overactive what is called a thyrotoxic crisis trigger, the power, among other things, by a sudden pain in the belly is noticeable. This metabolic derailment is a life-threatening condition that needs immediate medical care. Likewise, threatening the Hyper is kalzämische crisis, when the increased calcium in the blood is the trigger. The reason for the high calcium content of cancer are common diseases such as bone tumors, Multiple myeloma, or a tumor on the parathyroid gland.

Gynecological Causes

Pain in the right or left lower abdomen indicates organs in the small pelvis. In women, the fallopian tube inflammation, inflammation of the ovaries, fallopian tube or peritoneal cavity pregnancy (ectopic pregnancy), as well as handle the rolling of the ovary come here cysts in question, in men, Epididymitis, or testicular torsion. Also, think of a strangulated hernia (source hernia). (jvs, vb; updated on 29. April 2019)


  • Website of the professional Association of German internists, e. V. (last visit 01. April 2019)
  • Internet appearance of the German Red cross (last visit 01. April 2019)
  • S1-guideline “abdominal pain in children” the society for pediatric radiology (June 2017)