Acute Abdomen

EMERGENCY PROBLEMS OF THE GUT (ACUTE ABDOMEN)

Acute abdomen is a name given to a number of sudden, severe conditions of the gut for which prompt surgery is often needed to prevent death. Appendicitis, peritonitis, and gut obstruction are examples (see below). In women, pelvic inflammatory disease, or an out of place pregnancy can also cause an acute abdomen. Often the exact cause of acute abdomen will be uncertain until a surgeon cuts open the belly and looks inside.

If a person has continuous severe gut pain with vomiting, but does not have diarrhea, suspect an acute abdomen.

ACUTE ABDOMEN:

Take to a hospital surgery may be needed

• continuous severe pain that keeps getting worse
• constipation and vomiting
• belly swollen, hard, person protects it
• severely ill

LESS SERIOUS ILLNESS:

Probably can be treated in the home or health center

• pain that comes and goes (cramps)
• moderate or severe diarrhea
• sometimes signs of an infection, perhaps a cold or sore throat
• he has had pains like this before
• only moderately ill

If a person shows signs of acute abdomen, get him to a hospital as fast as you can.

Obstructed Gut

An acute abdomen may be caused by something that blocks or obstructs a part of the gut, so that food and stools cannot pass. More common causes are:

• a ball or knot of roundworms (Ascaris)
• a loop of gut that is pinched in a hernia
• a part of the gut that slips inside the part below it (intussusception)

Almost any kind of acute abdomen may show some signs of obstruction. Because it hurts the damaged gut to move, it stops moving.

Signs of an obstructed gut:

Steady, severe pain in the belly.

This child's belly is swollen, hard, and very tender. It hurts more when you touch it. He tries to protect his belly and keeps his legs doubled up. His belly is often silent. (When you put your ear to it, you hear no sound of normal gurgles.)

Sudden vomiting with great force! The vomit may shoot out a meter or more. It may have green bile in it or smell and look like feces.

He is usually constipated (little or no bowel movements). If there is diarrhea, it is only a little bit. Sometimes all that comes out is some bloody mucus.

Get this person to a hospital as fast as possible. His life is in danger and surgery may be needed.

Appendicitis, Peritonitis

These dangerous conditions often require surgery. Seek medical help fast.

Appendicitis is an infection of the appendix, a finger shaped sac attached to the large intestine in the lower right hand part of the belly. An infected appendix sometimes bursts open, causing peritonitis.

Peritonitis is an acute, serious infection of the lining of the cavity or bag that holds the gut. It results when the appendix or another part of the gut bursts or is torn.

Signs of appendicitis:

TESTS FOR APPENDICITIS OR PERITONITIS:

Have the person cough and see if this causes sharp pain in the belly.

Or, slowly but forcefully, press on the abdomen a little above the left groin until it hurts a little.

Then quickly remove the hand.

If a very sharp pain (rebound pain) occurs when the hand is removed, appendicitis or peritonitis is likely.

If no rebound pain occurs above the left groin, try the same test above the right groin.

IF IT SEEMS THAT A PERSON HAS APPENDICITIS OR PERITONITIS:

• Seek medical help immediately.

If possible, take the person where he can have surgery.

•  Do not give anything by mouth
• and do not give an enema. Only if the person begins to show signs of dehydration, give sips of water or Rehydration Drink made with sugar and salt but nothing more.
• The person should rest very quietly in a half-sitting position.

Note: When peritonitis is advanced, the belly becomes hard like a board, and the person feels great pain when his belly is touched even lightly. His life is in danger. Take him to a medical center immediately and on the way give him the medicines indicated above.