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Acute Abdomen: Symptoms, Causes & Treatment Options

Acute abdomen refers to sudden, severe abdominal pain and is considered a medical emergency requiring immediate diagnosis and care. A few other symptoms include fever, constipation, and bloody stool.

What is acute abdomen?

Acute abdomen refers to sudden, severe abdominal pain that is considered a medical emergency, requiring immediate diagnosis and often urgent surgical intervention. People of both genders and all ages are at risk for acute abdomen because it can have such varied causes.

Symptoms predominantly include severe abdominal pain. Fever, constipation, bloody stool, rebound tenderness in the abdomen, abdominal rigidity and guarding, bloating, jaundice, colic, and migratory pain may also occur.

Treatments vary for those in unstable and stable condition. Those in unstable condition require urgent surgery while those in stable condition might require surgery or other medical management based on their specific case.

Acute abdominal pain can represent a spectrum of conditions from benign and self-limited disease to surgical emergencies. It requires urgent management given how dangerous things could be.

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Acute abdomen symptoms

Main symptom

Severe abdominal pain is the main symptom of acute abdomen. However, it can be accompanied by a host of other symptoms.

Other symptoms

Further symptoms of acute abdomen include:

  • Fever
  • Constipation
  • Bloody stool
  • Rebound tenderness: When the abdomen is pressed deeply, more pain is felt upon removal of the pressure rather than the application of the pressure.
  • Rigidity: The abdomen feels very hard and stiff and worsens when touched.
  • Guarding: Reactive stiffening/hardening of the abdomen in response to pressure or touch is an involuntary reflex to prevent pain caused by any pressure on the abdomen.
  • Abdominal distention/stomach bloating
  • Jaundice: Yellowing of the skin or whites of the eyes results from excessive breakdown of red blood cells or obstruction of the bile duct near the liver.
  • Colic: Sharp, localized pain in the abdomen increases to a peak then subsides.
  • Migratory pain: Pain that begins above the belly button and migrates to the right lower quadrant of the abdomen is specific to certain conditions that can be very helpful in diagnosis.

Is acute abdomen serious?

If you have severe abdominal pain or pressure or pain in your chest

You should call 911 or seek immediate medical attention.

Contact your physician and seek prompt medical attention if you experience fever, jaundice, bloody stool, or bloating.

Acute abdomen causes

Having abdominal surgery is a risk factor of this condition. Causes can be divided into six large categories, including inflammatory, mechanical, neoplastic, vascular, congenital, and traumatic.


Irritation of the inner abdominal cavity or its lining (the peritoneum) can trigger inflammation leading to acute abdomen. Irritation and inflammatory acute abdomen can be triggered by:

  • Bacterial infections: Such as those that result in diverticulitis or appendicitis.
  • Peptic ulcers: If ruptures occur, peptic ulcers releases gastric acid that can irritate the perineum.


Mechanical causes include any action to the abdominal contents that can cause obstructions within the abdomen, such as:

  • Twisting
  • Malrotation
  • Herniation


Neoplastic refers to benign or malignant cancerous processes. Acute abdomen can occur when a tumor or mass within the abdomen presses upon organs or cause obstructions.


Acute abdomen may occur if the abdomen's blood supply is affected, such as by blockage from narrow arteries or by clots within the vessel.


Defects in the abdominal structure that are present at birth can result in inflammation or blood vessel problems that cause obstructions.


Direct damage to the abdomen in the form of trauma can cause acute abdomen, including:

  • Gunshot wounds
  • Stabbing
  • Mechanical vehicle accidents
  • Blunt abdominal injuries

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Acute abdomen treatments

Treatment for acute abdomen depends on careful evaluation and diagnosis of the most likely cause. Acute abdomen treatment options differ for people who are in stable condition and those who are not. Diagnoses may also differ in pregnant women and the elderly.

Those in unstable condition

This includes people who have severe abdominal pain with concerning and abnormal vital signs, including:

  • Fever
  • Low blood pressure
  • Increased heartbeat
  • Loss of consciousness

These individuals require urgent surgery (often called exploratory laparotomy) to find the cause of the acute abdomen. A bedside ultrasound can be used to quickly assess the abdomen and possibly pinpoint the area of concern; however, surgery should be done as soon and as quickly as possible.

Those in stable condition

This includes people experiencing severe abdominal pain who have normal vital signs and have not lost consciousness. A computed tomography (CT) scan may be performed, which may help guide physicians to the best, most appropriate treatment, whether that be surgery as above or medical management that can sometimes include antibiotics.

Questions your doctor may ask to determine acute abdomen

  • Have you experienced any nausea?
  • Are you sick enough to consider going to the emergency room right now?
  • Have you lost your appetite recently?
  • Have you been feeling more tired than usual, lethargic or fatigued despite sleeping a normal amount?
  • How long has your current headache been going on?

Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.” to end of doctor questions section.

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