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Acute abdomen from bailey love

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acute abdomen initial management guidelines adult surgical emergency assessment

Acute abdomen is a clinical syndrome of sudden abdominal pain and tenderness in which urgent diagnosis and treatment may be needed. It includes a wide range of surgical, medical, gynaecological, urological, and vascular emergencies. Bailey and Love emphasises that no single symptom, sign, blood test, or scan replaces repeated clinical assessment.

Topic map

  1. Definition and objectives of assessment
  2. Resuscitation and initial management
  3. History and pain patterns
  4. Examination, including peritonism
  5. Essential investigations and imaging
  6. Differential diagnosis by abdominal region
  7. Indications for urgent operation
  8. Special groups: pregnancy, children, older adults, immunocompromised patients

High-yield overview

  • First determine whether the patient is unstable or has generalised peritonitis, perforation, obstruction with strangulation, ischaemia, or uncontrolled haemorrhage. These need simultaneous resuscitation and early senior surgical input, not prolonged investigation.
  • Immediate measures: ABCDE assessment, monitoring, IV access, blood tests and cross-match, IV fluids/blood when indicated, analgesia and antiemetic, nil by mouth, urine output monitoring, pregnancy test where relevant, and antibiotics when sepsis or perforation is suspected.
  • The history should define onset, site, character, radiation, migration, severity, vomiting, bowel and urinary symptoms, menstrual/gynaecological history, previous surgery, drugs and comorbidity.
  • Examination includes general condition and vital signs, careful abdominal examination for guarding/rigidity/percussion tenderness, hernial orifices, rectal examination when relevant, and pelvic examination when indicated.
  • Imaging is selected according to the suspected pathology and patient group. CT is commonly important in adults with uncertain acute abdominal pain, while ultrasound is particularly useful for biliary, pelvic, and selected appendiceal pathology.
  • In non-pregnant women, Bailey and Love lists common lower abdominal causes as adnexal torsion, ovarian-cyst accident/rupture, pelvic inflammatory disease, endometriosis, appendicitis, and bowel obstruction. Bailey and Love's Short Practice of Surgery, 28th ed., section “Acute Abdomen” (pp. around the gynaecology acute-pain section).
Which part do you want in detail: 1) exam-style short note, 2) clinical approach and management algorithm, 3) differential diagnosis by site, or 4) investigations and imaging?

Almost everything as a final year medical student

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"acute abdomen" AND diagnosis

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adult acute abdominal pain assessment imaging guideline American College of Radiology 2025

A complete final-year note is best covered in modules so it remains usable for wards, viva, and exams. The core areas are:
  1. Initial resuscitation and decision for surgery
  2. History, examination, and peritonitis
  3. Investigations and imaging
  4. Differential diagnosis by pain location
  5. Major surgical causes: appendicitis, obstruction, perforation, ischaemia, pancreatitis, biliary disease
  6. Vascular, urological, gynaecological, and medical mimics
  7. Special populations and exam/viva pitfalls
Asking for Preferences

Which module should I cover in full first? I will then continue with the rest in a logical sequence.

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