Pattern of illnesses presenting as acute abdomen: surgical study in 118 patients


  • Rajesh Kumar Department of Surgery, MMMC&H, Kumarhatti, Solan, Himachal Pradesh, India
  • Mriganko S. Ray Department of Surgery and GI Surgery; SGT University, Gurugram, Haryana, India



Acute abdomen, Pain abdomen, Non-specific abdominal pain


Background: Acute abdomen is an important clinical entity and represents a symptom complex; of which, pain in the abdomen is a predominant feature. It is the result of some underlying condition and is a very common reason for patients reporting to emergency department. Pattern of illnesses presenting as ‘acute abdomen’ can vary from mild to life threatening in severity and management can similarly vary from just symptomatic relief to emergency operative intervention. It poses a significant challenge for the clinician since he is required to untangle the issue in a limited time frame and formulate a management plan. The aim of the study was finding the pattern of underlying conditions which had resulted in patients presenting with acute abdominal pain.

Methods: A prospective observational study was carried out on 118 patients who reported with ‘acute abdomen’, from August 2015 to February 2017.

Results: In this study, pattern of illnesses reflected that benign biliary disease was the commonest condition in the study population. This was followed by urolithiasis. An important observation was that ‘non-specific abdominal pain’ (NSAP) was the reason for acute abdomen in about 14% patients. Many other conditions like acute appendicitis, hollow viscus perforation, intestinal obstruction and pancreatitis presented with similar symptom complex in which abdominal pain was the main feature.

Conclusions: At the end of the study, we had a better knowledge of the conditions presenting as acute abdomen in the source population and the same can be utilized for further research in the field of this important clinical entity.

Author Biographies

Rajesh Kumar, Department of Surgery, MMMC&H, Kumarhatti, Solan, Himachal Pradesh, India



Mriganko S. Ray, Department of Surgery and GI Surgery; SGT University, Gurugram, Haryana, India

Professor, Surgery & GI Surgery;


Mosby. Mosby's Dictionary of Medicine, Nursing & Health Professions. 10th ed. Elsevier; 2016: 30.

Cartwright SL, Knudson MP. Evaluation of acute abdominal pain in adults. Am Fam Physician. 2008;77(7):971-8.

Martin RF, Rossi RL. The acute abdomen. An overview and algorithms. Surg Clin North Am. 1997;77(6):1227-43.

Falch C, Vicente D, Haberle H, Kirschniak A, Muller S, Nissan A, Brucher BL. Treatment of acute abdominal pain in the emergency room: a systematic review of the literature. Eur J Pain. 2014;18(7):902-13.

Schein M, Rogers PN, Leppaniemi A, Rosin D, Efron JE. Schein's Common Sense Emergency Abdominal Surgery. 4th ed. 2015.

Toorenvliet BR, Bakker RF, Flu HC, Merkus JW, Hamming JF, Breslau PJ. Standard outpatient re-evaluation for patients not admitted to the hospital after emergency department evaluation for acute abdominal pain. World J Surg. 2010;34(3):480-6.

Leung AK, Sigalet DL. Acute abdominal pain in children. Am Fam Physician. 2003;67(11):2321-6.

Hendrickson M, Naparst TR. Abdominal surgical emergencies in the elderly. Emerg Med Clin North Am. 2003;21(4):937-69.

Hardy A, Butler B, Crandall BSM. The evaluation of the acute abdomen. In: Moore LJ, Turner KL, Rob TS, eds. Common problems in acute care surgery. New York: Springer Publishing Company; 2013: 19-30.

Soon Y, Hardy RG. Acute abdomen. Surgery. 2002;58:169-72.

Dang C, Aguilera P, Dang A, Salem L. Acute abdominal pain. Four classifications can guide assessment and management. Geriatrics. 2002;57(3):30-2.

Chaudhry AK, Azam M. An etiological spectrum of mechanical intestinal obstruction: a study at Lahore Garrison. Pak Armed Forces Med J. 2004;54(1):19-24.

Gondal SH, Gulshan S, Ullah N. Intestinal tuberculosis as an abdominal emergency. Pak Postgrad Med J. 2000;11:103-5.

Memon AA, Bhutto AA, Shaikh GS, Jokhio A, Soomro Q. Spectrum of diseases in patients with non-traumatic acute abdomen. J Liaquat Uni Med Health. 2008;7(3):180-3.

Powers RD, Guertler AT. Abdominal pain in the ED: stability and change over 20 years. Am J Emerg Med. 1995;13(3):301-3.

Abbas SM, Smithers T, Truter E. What clinical and laboratory parameters determine significant intra abdominal pathology for patients assessed in hospital with acute abdominal pain?. World J Emerg Surg. 2007;2:26.

Chanana L, Jegaraj MA, Kalyaniwala K, Yadav B, Abilash K. Clinical profile of non-traumatic acute abdominal pain presenting to an adult emergency department. J Family Med Prim Care. 2015;4(3):422-5.

Berhane Y, Girmay K, Gebresilassie A. Outcome of emergency surgical operations performed for non-traumatic acute abdomen among adults in Mekellehospital. European J Pharm Med Res. 2016;3(14):106-11.

Singh G, Dogra BB, Jindal N, Rejintal S. Non-traumatic ileal perforation: a retrospective study. J Family Med Prim Care. 2014;3(2):132-5.

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

Ohene YM. Acute surgical admissions for abdominal pain in adults in Kumasi, Ghana. ANZ J Surg. 2006;76(10):898-903.

Agboola JO, Olatoke SA, Rahman GA. Pattern and presentation of acute abdomen in a Nigerian teaching hospital. Niger Med J. 2014;55(3):266-70.

Zahid M, Jamal AU, Akhtar S, Shah TA. Critical review of acute appendicitis in females. Ann KE Med Uni. 2004;10:283-6.

Steele RJC, Cuschieri A. Patients undergoing emergency general surgical operations. In: Cuschieri A, eds. Essential surgical practice. 4th ed. London: CRC Press; 2000: 393-414.

Powers RD, Guertler AT. Abdominal pain in the ED: stability and change over 20 years. Am J Emerg Med. 1995;13(3):301-3.

Dombal FT, Leaper DJ, Staniland JR, Cann AP, Horrocks JC. Computer-aided diagnosis of acute abdominal pain. Br Med J. 1972;2(5804):9-13.

Kotiso B, Abdurahman Z. Pattern of acute abdomen in adult patients in Tikur Anbesa Teaching Hospital, Addis Ababa, Ethiopia. East Cent. Afr J Surg. 2006;12(1):47-52.






Original Research Articles