The surgical abdomen cannot wait: separate early what can be observed from what goes to theatre.
Ruptured abdominal aortic aneurysm
Abdominal/back pain + hypotension + pulsatile mass in the elderly — immediate ultrasound.
Mesenteric ischemia
Pain out of proportion to examination in an AF patient.
Hollow viscus perforation
Rigid abdomen + free air under the diaphragm.
Ruptured ectopic pregnancy
Every woman of childbearing age with abdominal pain: pregnancy test before anything.
Elderly, diabetic, immunosuppressed abdomens "lie" — keep a low imaging threshold.
Periumbilical pain in an elderly AF patient = mesenteric ischemia until proven otherwise.
Nil by mouth, IV line, comfortable transport with analgesia.
Migration to the right iliac fossa, anorexia.
RUQ pain after fatty food, Murphy sign.
Band-like pain to the back, lipase > 3× normal.
Distension, vomiting, absolute constipation, previous surgery.
Colicky loin-to-groin pain with hematuria.
Warning
Elderly + abdominal pain + hypotension = ruptured aneurysm until proven otherwise. Echo at the bedside — do not send the patient to radiology.
بنية العرض مقتبسة من Notfallguru.de بموافقة فريقه — المحتوى بانتظار مراجعتهم
This content is an educational reference and does not replace clinical judgement or local protocols.
