Role of Intensive Care Unit in The Management of Non -Traumatic Acute Abdomen

Abstract

Abdominal pain is one of common problems encountered by doctors, either in primary or secondary health care. It may be mild, but it may also be a life threatening sign. It has been estimated that almost 50 % adults have experienced abdominal pain and it accounts for 5-10 % of all emergency visits. A general understanding of abdominal anatomy, physiology and pathophysiology is vital when formulating a differential diagnosis for abdominal pain. In addition, it is important to understand how abdominal pain is generated and perceived by the patient. Physicians must take into account the patient's age and gender, as conditions associated with the acute abdomen may vary accordingly. Key features of the history include the dimensions of pain. Examination of the abdomen should include inspection, auscultation, percussion, and palpation of all areas of the abdomen. Radiologic imaging plays a key role in the evaluation and management of the acute abdomen. Plain films, ultrasound (US), computed tomography (CT), and magnetic Resonance imaging (MRI) are the most common imaging modalities employed in the diagnostic workup of these patients Prompt diagnosis and resuscitation and prompt treatment of underlying condition with antibiotics and surgical correction form the cornerstones of treatment. Patients with an acute abdomen often need to be admitted to an Intensive Care Unit peri-operatively for monitoring and management of surgical and medical complications. Major systems may require support with fluids, inotropes, airway care, ventilation and renal replacement therapy. Other supportive care includes nutrition, good nursing care and wound care. We discussed briefly the most important causes of acute abdomen in critically ill patients which are: acute mesenteric ischemia, acute myocardial infarction, acute pancreatitis, bowel rupture, diabetic ketoacidosis, large intestinal obstruction, pseudomembranous colitis, ruptured abdominal aortic aneurysm and small intestinal obstruction.