ACUTE ABDOMEN LIVE HELD ON 04/06/2019 ON INSTAGRAM Acute abdomen is defined as a syndrome whose main symptom is abdominal pain, which leads the patient to seek care and requires treatment, whether clinical or surgical. If left untreated, it will lead to a deterioration of the general condition. Trauma is not an acute abdomen! The pain must be of non-traumatic origin! Any peritoneal or retroperitoneal viscera can be the cause. The secret is to characterize the abdominal pain well: type, onset, periodicity, radiation, location, intensity, factors of improvement and worsening. And also ask about associated symptoms: nausea, vomiting, fever, jaundice, choluria and acholia feces, digestive hemorrhage, weight loss, dysuria, leucorrhea, menstrual changes, changes in bowel habits, etc. The physical examination should be detailed, with special attention to the abdomen and search for signs of peritonitis, such as positive abrupt decompression and involuntary muscle contraction. Tests such as a complete blood count and type 1 urine test can be performed and help in the diagnostic reasoning. There is no list of routine tests for acute abdomen and each case must be individualized. An acute abdomen X-ray should be performed whenever possible: chest X-ray in PA and abdominal X-ray in standing and lying positions. These are essential in perforative and obstructive acute abdomen, but can be performed in all types of acute abdomen. Abdominal ultrasound is an excellent test for inflammatory acute abdomen because it shows collections, abscesses, wall thickenings such as the appendix and gallbladder, and is an excellent complement to gynecological organs through transvaginal ultrasound. CT scan is an excellent exam for massive viscera and retroperitoneum, and is also interesting for inflammatory conditions such as appendicitis, diverticulitis and acute pancreatitis. Acute abdomen is didactically divided into 5 different syndromes, each with several etiologies, the main ones being: Inflammatory acute abdomen: acute appendicitis Obstructive acute abdomen: adhesions and adhesions Perforative acute abdomen: perforated peptic ulcer Vascular acute abdomen: embolism of the superior mesenteric artery Hemorrhagic acute abdomen: ruptured ectopic pregnancy The important thing is the syndromic diagnosis and the definition of conduct, without wasting time on etiological investigation. Surgery is often indicated without knowing the etiological diagnosis, but we know that it is necessary to operate when there is peritonitis, for example! Follow on Instagram / drfabiocolagrossi • ACUTE ABDOMEN