Dr.Dinesh.M.G Professor of Surgery J.J.M.M.C Davangere

1. Dr. Dinesh. M.G
Professor of Surgery
J.J.M.M.C.
Davangere

2. Evaluation of pain in acute abdomen
 Abdominal pain one of the most common conditions that
calls for prompt diagnosis and treatment
 To attempt a specific diagnosis prevents carelessness
 It is also true to say that correct diagnosis is preliminary to
correct treatment

3. Introduction
 Introduction and its
importance
 Common surgical conditions
 Acute appendicitis
 Peptic ulcer perforation
 Acute pancreatitis
 Acute cholecystitis
 Acute intestinal obstruction
 Intussusception
 Mesenteric ishchaemia
 Peritonitis
 Primary
 Secondary
 Ureteric colic
 Pyelonephritis
 Ectopic pregnancy
 Ovulation
 Twisted ovarian cyst
 Salpingitis
 Rare causes
 Porphyria
 Diabetes mellitus
 Mesenteric adenitis
 Viral fever eg dengue
 HIV
 Henoch Schonlein purpura
 Ruptured abdominal
aneurysm

4. Evaluation of pain in acute abdomen
Principles in evaluation
1. Necessity of making a diagnosis by means of history and
physical examination
2. One can not over emphasize the need to make early
diagnosis because problem lies in delay than in the
pathology
 Analgesics can be given after a quick working diagnosis is
made
3. Most often patients come to hospital late in the evening or
night after enduring the pain in the day time. So important
decisions have to be taken in the night when the doctors
are physically and mentally below their best

5. Evaluation of pain in acute abdomen
 In general it can be said that majority of severe abdominal
pain that ensue in patients who were previously fairly well
and that last as long as 6 hours are caused by conditions of
surgical importance.
4. Thorough history taking and physical examination in
every acute abdominal case can not be overemphasized
5. Knowledge of anatomy
6. Knowledge of physiology