acute abdomen 1

2. Acute abdomen
The 'acute abdomen' is a clinical condition
characterized by severe abdominal pain, requiring
the clinician to make an urgent therapeutic decision.

3. This may be
challenging, because
the differential
diagnosis of an acute
abdomen includes a
wide spectrum of
disorders, ranging
from life-threatening
diseases to benign
self-limiting
conditions

4. Radiological approach
Plain X ray
Acute abdominal
series

5. Modified acute series

6. Ultrasonography

7. CT Scan

8. Right hypochondrial pain
 Acute hepatitis
 Gallstones
 Acute cholecystitis
 Peptic ulcer
 Renal colic
 Pyelonephritis

9. Normal Liver Ultrasound

10. Acute viral hepatitis
 Patients often present with fever, abdominal pain,
and jaundice.
 Multiple serum lab values are often elevated,
including AST, ALT, and GGT.

11. Normal Gallbladder

12. Ultrasonography

13. CT

14. Gall stones

15. Acute Cholecystitis
 Calculi in the gallbladder
(GB),
 Anterior GB-wall thickness
of >3 mm
 Positive Murphy sign (pain
on compression of the GB
with the ultrasonographic
probe)
 Hypervascularization of
the GB wall on color-flow
and power Doppler images

16. Two major or 1 major and 2 minor criteria need
to be present to achieve a diagnosis
The major criteria include the following:
 GB-wall thickening of more than 3 mm
 A striated GB wall
 A positive sonographic Murphy sign
 Mucosal sloughing
 Pericholecystic fluid
 Intramural gas
Minor criteria include:
 Sludge within the GB.
 GB dilatation of greater than 5 cm in
transverse diameter.

17. Chronic cholecystitis

18. CT

19. Biliary obstruction

21. Liver cirrhosis