Common acute abdominal diseases include acute appendicitis, gastrointestinal perforation, cholelithiasis, acute pancreatitis, cystitis, urinary tract stones, ectopic pregnancy, uterine rupture, ovarian corpus luteum rupture, acute intestinal obstruction, etc.

Symptoms include abdominal pain, bloating, nausea, vomiting, diarrhea, etc. Pain types mainly include distension, stinging, burning pain, knife-like pain, drilling pain, colic, etc. Pain types can also provide ideas for diagnosis. .

General information: patient’s age, gender, occupation, marital status, home address, etc.

Chief Complaint: Symptoms and Duration

History of current illness: Severe abdominal pain, knife-like pain indicates perforation of the gastrointestinal tract, which will spread to the entire abdomen. If it is finally limited to the right lower abdomen, it indicates appendicitis. Is there nausea and vomiting? If so, what is the nature of the vomit, whether there is blood, and upper gastrointestinal perforation. Bleeding will lead to vomiting blood. Other symptoms, if the exhaust gas stops, indicate the possibility of intestinal obstruction, and there is fever. Fever indicates the possibility of verification.

Past history: past health status, disease history, infectious disease history, vaccination history, surgical trauma history, blood transfusion history, allergy history, etc.

Personal history: social experience, occupation and working conditions, habits and hobbies, history of unclean sexual intercourse, etc.

Family history: family history of disease, etc.

Marital and childbearing history: Women should pay attention to ask about their menstrual status and whether they are in the ovulation period.

Inspection: Check whether the abdomen is distended, whether there are ecchymoses, whether there are venous distensions, whether there are abnormalities in the navel, whether there are gastrointestinal peristaltic waves, the presence of ecchymosis indicates acute pancreatitis, and the presence of gastrointestinal peristaltic waves indicates the gastrointestinal tract Possibility of obstruction

Auscultation: Listen for active bowel sounds, increased intestinal peristalsis, then weakened, acute abdomen progressively enhanced, presence or absence of vibrating water sounds, if there are vibrating water sounds, consider pyloric obstruction or gastric dilatation, and listen for the presence of vascular murmurs

Percussion: normal drum sound, if it is moving dullness, fluid wave tremor, gurgling sound indicates ascites, percussion of liver dullness boundary, it does not mean perforation

Palpation: Palpation of the spleen for enlargement, palpation of the gallbladder (a positive Murphy's sign indicates the possibility of cholecystitis), whether the abdomen is soft or hard, soft is medical, hard is surgical, tenderness, rebound tenderness, muscle tension, and platelet Abdominal peritonitis is very serious. Start touching the less severe areas and fix the location of the lesion wherever the pain point is.

After medical history collection and abdominal examination, gastrointestinal perforation is seriously suspected. The following auxiliary examinations are performed to support the judgment.

Blood routine: Check white blood cell count, neutrophil ratio, C-reactive protein and other indicators. Usually there will be an increase in gastrointestinal perforation.

Biochemical examination: Blood amylase is elevated, which is common in pancreatitis and gastrointestinal perforation.

Urine routine: Is there any bleeding in the urine? This test is more meaningful for men. The presence of blood cells in the urine indicates the possibility of urinary stones. Women have errors due to menstruation.

Stool routine: Perforation of the lower gastrointestinal tract will cause black stools, and peritoneal irritation signs will appear early.

Upright abdominal plain radiograph: If free air is seen under the right diaphragm, it is more certain to be gastrointestinal perforation.

Electrocardiogram: Some heart diseases can also cause abdominal pain

Whole-abdominal CT: Exclude diseases that cannot be ruled out by the above conditions, such as pancreatitis that is difficult to identify and diseases of female pelvic organs such as the uterus and ovaries.