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Chapter 25. ACUTE ABDOMEN IN GYNECOLOGY

25.1. NOTION OF ACUTE ABDOMEN

ICD-10 Code

R10.0 Acute abdomen.

General Information

The term acute abdomen is only used in the framework of making a preliminary diagnosis when referring the patient to hospital.

According to the definition by the Russian association of Medical Communities (2007), acute abdomen is a term to designate that a disastrous condition in the abdominal cavity is assumed (peritonitis, intra-abdominal bleeding) so that emergency care is required.

NB! From the clinical point of view acute abdomen is a complex of signs with pain of sudden onset in any portion of the abdomen as the leading presentation; the pain is accompanied by peritoneal signs and pronounced deterioration of the patient?s condition.

Since internal genitals are anatomically proximal to other abdominal organs, when clinical signs of acute abdomen arise, one has to differentiate between acute gynecological and surgical conditions. One should also take into consideration other causes of acute abdomen (see section Classification).

NB! Acute abdomen is a syndrome. The diagnosis must be further differentiated.

Epidemiology

Epidemiology of acute abdomen depends on the prevalence of acute abdominal conditions which may cause peritonitis or intra-abdominal bleeding.

Among the causes of intra-abdominal bleeding, ovarian apoplexy accounts for up to 2.5%. According to summary statistics, necrosis of uterine fibroid is responsible for 7% of peritonitis cases. Adnexal torsion constitutes 5-7% in the structure of acute gynecological morbidity. Ectopic pregnancy rates the fourth among the causes of maternal mortality (2.6% of all cases). Etiology of acute abdomen is directly dependent on the underlying cause which brought about the emergency.

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