Acute Abdomen Surgery Exam Booster

Table of Contents introduction to Acute Abdomen  .Embryology of Abdominal Pain.    Types of Pain (Visceral vs Somatic vs Referred)     .Important Clinical  Signs     .Differential Diagnosis by Region     .Red Flags & Emergency Cases     .High-Yield Exam Points 

Duration 35_40 min 

  Teaching Method Interactive Style    .Case-Based Learning  Visual Mapping. Pattern Recognition High-Yield Triggers . Exam Techniques

Acute abdomen is a sudden onset of severe abdominal pain that requires urgent evaluation and may need surgical intervention. Common causes include inflammatory conditions like appendicitis and cholecystitis, obstruction, perforation, vascular causes such as mesenteric ischemia, and gynecological causes like ectopic pregnancy. Red flag signs include shock, abdominal rigidity, and rebound tenderness. Management starts with ABC stabilization, IV fluids, keeping the patient NPO, giving analgesia and antibiotics if needed, and urgent surgical consultation. Pain out of proportion to examination strongly suggests mesenteric ischemia

Embryological origin explains abdominal pain location: foregut → epigastric pain, midgut → periumbilical pain, hindgut → suprapubic pain. Visceral pain is dull and poorly localized, while somatic pain is sharp and well localized. Example: appendicitis starts as periumbilical pain then shifts to the right lower quadrant.

Murphy’s sign: pain and arrest of inspiration on palpation of the right upper quadrant → acute cholecystitis

Related important signs:

• McBurney’s point tenderness: RLQ pain → appendicitis
• Rovsing’s sign: LLQ pressure causes RLQ pain → appendicitis
• Psoas sign: pain on hip extension → retrocecal appendicitis
• Obturator sign: pain on internal rotation of hip → pelvic appendicitis
• Grey Turner sign: flank bruising → hemorrhagic pancreatitis
• Cullen sign: periumbilical bruising → intra-abdominal bleeding / pancreatitis