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Abdominal emergencies

Abdominal pain is a common presentation, delays in diagnosis and management can complicate the patient outcome.

Achieving the balance between safe and expedient assessment versus delay and over investigation is the key in managing abdominal pain presentations.

Specific Conditions

    Red flags



    Immunocompromised (e.g. HIV, chronic steroid treatment, renal failure, transplant patients and cancer patients on chemotherapy)

    Multiple comorbidities

    Previous abdominal surgery

    Cardiac disease (AF, IHD)



    Sudden onset, sever or constant pain

    Physical examination


    Tachycardia, hypotension

    Signs of shock

    Rigid abdomen

    Involuntary guarding

    Paediatric Abdominal Emergencies

    This clinical tool deals with surgical abdominal emergencies in adults.

    Useful resources for management of paediatric abdominal emergencies can be found here.

    Further References and Resources

    Red Flag Education

    An real case highlighting issues in the management of abdominal pain is detailed below:

    Red flag module on abdominal pain

    Relevant Patient Factsheets

    • Abdominal pain
    • Appendicitis
    • Bleeding in early pregnancy
    • Constipation
    • Diarrhoea and vomiting
    • Diverticular disease
    • Gallstones
    • Gastro-Oesophageal Reflux Disease (GORD)
    • Kidney Stone
    • Pelvic Inflammatory Disease
    • Peptic Ulcer Disease (PUD)

    Relevant Procedure Guides

    • Circulation - Intraosseous access
    • Circulation - Venepuncture
    • Gastroenterology - Paracentesis
    • Obs and Gynae - Speculum exam
    • Ultrasound - Abdominal aorta
    • Ultrasound - Biliary
    • Ultrasound - FAST
    • Ultrasound - Pregnancy (abdominal)
    • Ultrasound - Renal

    Original: Dr John Mackenzie

    Update: Dr James Miers

    Reviewer: Dr Michael Golding

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