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Primary Assessment

A focused yet complete physical examination for acute abdomen patients is critical for early identification and initiation of treatment for potentially life‐threatening problems. Primary patient assessment should follow the ABC method of evaluating the patient's airway, breathing, and circulation status. The ABC evaluation should be followed by examination of the major body systems, palpation of the abdomen, and a complete physical examination. For a complete discussion of initial triage, see Chapter 1.

Table 3.1 Etiologies of acute abdomen.

Source: Adapted from Beal [2].

System/organ	Condition
Gastrointestinal	Gastric dilatation/volvulus^a
Gastric ulceration/perforation^a
Gastric or small bowel obstruction^a
Gastric or small bowel ischemia^a
Intussusception^a
Colonic torsion^a
Gastroenteritis
Neoplasia
Urologic	Bladder, ureteral, or urethral disruption^a
Bladder, ureteral, or urethral obstruction^a
Nonobstructive urolithiasis
Infection: cystitis, pyelonephritis
Neoplasia^a
Ischemia
Hepatobiliary	Hepatic abscess^a
Hepatic torsion^a
Hepatitis
Hepatic laceration^a
Cholangiohepatitis
Biliary obstruction^a
Cholecystitis
Gall bladder mucocele^a
Cholelithiasis
Biliary disruption^a
Spleen	Torsion^a
Neoplasia^a
Hematoma
Laceration
Infarction^a
Pancreas	Pancreatitis
Pancreatic abscess^a
Pseudocyst^a
Neoplasia
Peritoneum	Septic peritonitis^a
Uroperitoneum^a
Bile peritonitis^a
Inflammatory peritonitis
Hemoperitoneum^a
Disseminated neoplasia
Mesenteric rent^a
Mesenteric volvulus^a
Reproductive system:
Male	Prostatitis, prostatic abscess^a
Prostatic/periprostatic cyst^a
Neoplasia
Testicular torsion^a
Female	Pyometra^a
Uterine rupture^a
Neoplasia

^a Surgical conditions or those that may benefit from surgical intervention.

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