Acute abdomen is the most common emergency in general surgery. An acute abdomen refers to a sudden, severe abdominal pain. It is in many cases a medical emergency, requiring urgent and specific diagnosis. Acute abdomen refers to abdominal symptoms and signs of such severity or concern that disorders requiring surgery should be considered.
Etiology
Many conditions that cause acute abdomen. In general, these circumstances are grouped in four areas:
Bacterial - chemical inflammation processes
Mechanical obstruction
Neoplasm / tumor
Vascular disorder
Clinical Manifestations
a. Visceral pain
Visceral pain occurs when there is a stimulus to the organs / structures in the abdominal cavity. Visceral peritoneum that surrounds the abdominal organs are innervated by the autonomic nervous system and is not deaf to palpation. But when done strain organ / excessive contraction in the muscles that cause ischemia will be pain. Visceral pain also called as central pain.
b. Somatic pain
Stomatik pain occurs because the stimulus organ / on parts supplied by the peripheral nerves, and the wound in the abdominal wall. Pain is felt as stabbed with a finger. These painful stimuli such as palpation, pressure stimulation chemical / inflammatory processes.
Friction between visceral inflamed, provoking peritoneum and cause pain. The inflammation itself or the friction between the peritoneum causing changes in pain intensity. This explains the movement of contra lateral pain in acute appendicitis.
The Nature of Pain
1) Referred pain
Pain felt at a site other than where the cause is situated. An example is the pain from the pancreas, the which is felt in the back. Pain in the internal organs is Often Referred to sites distant from them.
2) Radiating pain
is a sign that a nerve or nerve root along the spinal column is under pressure from injury or inflammation. It is a common symptom of many spinal conditions and manifests itself as pain that travels the length of a nerve - for instance, down an entire arm or leg.
3) Projection Pain
Projected pain is pain that is caused by stimulation of sensory nerve injury or inflammation of the nerves.
4) Hyperalgesia / Hyperesthesia
Hyperalgesia / Hyperesthesia often found in the skin if there is inflammation of the cavity underneath. In severe stomach this sign often found in the local peritonitis, or generalized peritonitis. Pain arising in patients with acute abdominal pain may be continuous / pain that is colicky.
5) Colic
Colic is a form of pain that starts and stops abruptly. It Occurs due to muscular contractions of a hollow tube (colon, ureter, gall bladder, etc.) in an attempt to relieve an obstruction by forcing content out.
6) Ischemic pain
Ischemic pain is a sign of threatened tissue necrosis, more shall appear the sign of intoxication due to reabsorption of toxins from tissue necrosis.
Nursing Diagnosis for Acute Abdominal Pain
1. Acute pain related to biological agents injury, obstruction / duct spasm, inflammation, ischemic tissue / necrosis
2. Imbalanced Nutrition: less than body requirements related to impaired absorption of nutrients, hyper-metabolic status
3. Risk for Infection, Risk for major defense against inadequate; perforation / rupture in the appendix, peritonitis, abscess formation
4. Knowledge deficit (need to learn) about the condition, prognosis and treatment needs related to misinterpretation of information, lack of recall
