An acute abdominal condition is characterised by the abrupt onset of abdominal pain, distention, diminished or absent bowel sounds, and, sometimes, guarding. There may be many causes of these symptoms, and the disorder within the abdomen is hidden. In addition to a routine external physical assessment, seven routes of diagnostic work-up are used. Less invasive testing is usually performed initially. 

Laboratory studies include coagulation studies, haemoglobin and hematocrit tests, and blood volume determinations to rule out internal bleeding, leukocyte differential to determine whether an infectious or inflammatory process is present, amylase level to rule out pancreatic and other pathologic conditions, liver panels to rule out a hepatic disorder, blood urea nitrogen and creatinine determinations and urinalysis to rule out urinary tract infection, and stool examination to rule out Salmonella. Fine-needle aspiration cytologic testing provides clues to the type of process occurring. 

Plain-film radiography is taking a radiograph without the use of an injected radiopaque agent. Plain-film radiography of the abdomen may identify compression fractures, intestinal obstruction, metastasis, perforated abdominal viscus, pancreatic calcification, and renal calculi. 

Contrast radiography involves the injection of a radiopaque agent into the vascular space. The contrast agent enhances the appearance of organ and vascular lumens and is more likely to reveal a pathologic condition than is plain film radiography. Vascular contrast examinations of the abdominal area, such as intravenous pyelography, help identify lumbar aortic aneurysms, urinary tract trauma, lesions, or other disorders. 

Intestinal contrast examinations such as barium enema, oral cholecystogram, and upper gastrointestinal series may identify colonic lesions or perforation but should not be performed when an obstruction is suspected. They may also rule out appendicitis. 

Ultrasonography may help diagnose acute abscesses, cholecystitis, Crohn’s disease, dilated bile duct, hepatic cancer, hepatic or splenic hematoma, hydronephrosis, intussusception, pancreatitis, pancreatic pseudocyst, pancreatic carcinoma, splenomegaly, urinary tract obstruction, and the presence of foreign bodies. 

Computed tomography helps identify, differentiate, and evaluate hepatic, pancreatic, renal, and retroperitoneal abscesses, fluid accumulations, masses and cysts, and pancreatitis. 

Nuclear medicine studies help identify intra-abdominal abscesses, sites of gastrointestinal bleeding, hematoma, and areas of abnormal tissue metabolism. Nuclear medicine scans may also help to rule out cholecystitis. 

In extremely acute situations and when findings from any combination of the above tests are inconclusive, surgical exploration of the abdomen may be required. 


About Genomic Medicine UK

Genomic Medicine UK is the home of comprehensive genomic testing in London. Our consultant medical doctors work tirelessly to provide the highest standards of medical laboratory testing for personalised medical treatments, genomic risk assessments for common diseases and genomic risk assessment for cancers at an affordable cost for everybody. We use state-of-the-art modern technologies of next-generation sequencing and DNA chip microarray to provide all of our patients and partner doctors with a reliable, evidence-based, thorough and valuable medical service.