Surgical Approach to the Acute Abdomen

Acute abdomen refers to the sudden onset of severe abdominal pain of unclear cause, implying concern for an urgent pathology. Many, but not all, of the diagnoses in the differential are surgical or potentially surgical in nature. This chapter reviews key distinctions in the history, physical examination, diagnostic workup, and important communication with surgical consultants. Surgical and nonsurgical diagnoses in the differential are reviewed according to the location of abdominal pain and patient demographics. The surgical management of peptic ulcer disease, pancreatitis, Crohn disease, diverticulitis, colonic volvulus, toxic megacolon, Ogilvie syndrome, and complications of endoscopy are reviewed.