Published: 2019-04-29

The non traumatic acute abdomen and its clinical spectrum

M. Srujan Kumar, Bharath B., K. S. Balasubramanya, K. Thinagaran


Background: Acute abdomen poses a big challenge to the general surgeons in terms of both diagnosis and management. The aim of this study was to know in detail the clinical and postoperative outcome in non traumatic acute abdomen.

Methods: Prospectively collected data of 326 patients with non traumatic acute abdomen admitted in PES institute of medical sciences and research, Kuppam from November 2016 to June 2018. All patients were subjected to clinical examination, relevant blood and imaging investigations, Intra and postoperative findings events were recorded.

Results: Non traumatic acute abdominal pain was more common in 2nd to 5th decade of life. Males are more affected than females with a male to female ratio of 3.4:1. Acute appendicitis forms the commonest cause of acute abdomen (n=160=49%) followed by perforative peritonitis (n=85=26%). Most common surgical procedures done were laparoscopic/open appendectomy for acute appendicitis, exploratory laparotomy with Graham’s omentoplasty for perforative peritonitis.

Conclusions: Systematic approach in history taking and a proper clinical examination with supportive imaging findings are most important in making an accurate diagnosis and need of appropriate surgical intervention in patients with non traumatic acute abdomen.


Acute appendicitis, Non traumatic acute abdomen, Perforated peptic ulcer

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Sethuraman U, Siadat M, Lepak-Hitch CA, Haritos D. Pulmonary embolism presenting as acute abdomen in a child and adult. Am J Emerg Med. 2009;27:514.e1-5.

Irvin TT. Abdominal pain: a surgical audit of 1190 emergency admissions.Br J Surg. 1989;76:1121-5.

Grundmann RT, Petersen M, Lippert H, Meyer F. Das acute (chirurgische) Abdomen Epidemiologie, Diagnostik und allgemeine Prinzipien des Managements. Z Gastroenterol. 2010;48:696-706.

Venkateswarlu MC, Chandrakala G, Aiswarya, Study of Diseases In Patients With Non Traumatic Acute Abdomen. IOSR. 2015;14(10):15-9.

Sala E, Watson CJ, Beadsmoore C, Groot-Wassink T, Fanshawe TR, Smith JC, et al. A randomized, controlled trial of routine early abdominal computed tomography in patients presenting with nonspecific acute abdominal pain. Clin Radiol. 2007;62:961-9.

Tintinalli J. Tintinallis emergency medicine A comprehensive study guide. 8th ed. McGraw-Hill Education; 2015.

Note M. The Acute Abdomen. In: Slip M, Rogers PN, ed bill's Common Sense Emergency Abdominal Surgery. 2nd ed. Berlin, Heidelberg: Springer; 2005:19-25.

Sheridan WG, White AT, Havard T, Crosby DL. Nonspecific abdominal pain: the resource implications. Ann R Coll Surg Engl. 1992;74:181-5.

Jeffrey Hopkins, Lynn Farrugia, Maureen Suchenski. MACEP Risk Management Course Module 1: Abdominal Pain. Available at: Accessed on 25 April 2019.

Smith MP, Katz DS, Lalani T, Carucci LR, Cash BD, Kim DH, et al. ACR Appropriateness Criteria right lower abdominal pain suspected appendicitis. Ultrasound Q. 2015;31(2):85-91.

McConkey SJ. Case series of acute abdominal surgery in rural Sierrra Leone. World J Surg. 2002;26:509-13.

Ohene-Yeboah M. Acute surgical admissions for abdominal pain in adults in Kumari, Ghana. Aust. N Zealand J Surg. 2006;76:898-903.

Séréngbé BG, Gaudeuille A, Soumouk A, Gody JC, Yassibanda S, Mandaba JL. Acute abdominal pain in children at the Pediatric Hospital in Bangui (Central Africa Republic). Epidemiological, clinical therapeutic and evolutive aspects. Arch Pediatr. 2002;9:136-41.

Adesunkanmi ARK, Oseni SA, Adejuyigbe O, Agbakwuru EA. Acute generalized peritonitis in African children: assessment of severity of illness using modified APACHE II score. ANZ J Surg. 2003;73:275-9.

Ohene-Yeboah M. Causes of acute peritonitis in 1188 consecutive adult patients in Ghana. Trop Doctor. 2005;35:84-5.

Kesarwani A, Pardeshi CZ, Das AG, Yadav P, Khairnar N. The acute abdomen: a comparative analysis of clinical, radiological and operative findings. World J Pharmaceu Med Res. 2018;4(6):183-9.

Barai B, Mandal A, Chakraborty P, Bhattacharya S, Bala S. Spectrum of Diseases in Patients with Non-Traumatic Acute Abdominal Pain Presenting to General Surgery Department in a Rural Tertiary Care Centre in West Bengal. IJSR. 2016;5(3):1244-8.

Jain R, Gupta V. A prospective study of epidemiology and clinical presentation of non-traumatic acute abdomen cases in a tertiary care hospital of central India. Int Surg J. 20163;4(1):242-5.

Ray S, Patel M, Parmar H. Management of acute abdomen: Study of 110 cases. IAIM. 2016;3(2):18-24.

Hagos M. Acute abdomen in adults: a two year experience in Mekelle, Ethiopia. Ethiopian Med J. 2015;53(1):19-24.

Chavan DK, Kannur S, Metan BB, Kullolli G. A prospective study on geriatric abdominal surgical emergencies. Int J Res Med Sci. 2014;2(3):963-71.