Dtsch Med Wochenschr 2020; 145(21): 1535-1543
DOI: 10.1055/a-1007-4174

Das akute Abdomen: Ätiologie und Klinik

The Acute Abdomen: Etiology and Clinical Presentation
Sylvia Pemmerl
Andreas Hüfner

Der Begriff „akutes Abdomen“ umfasst eine Vielzahl von Erkrankungen, die häufig im Bauchraum auftreten, meist akut einsetzen und von Symptomen wie Übelkeit und Erbrechen begleitet sein können. Die Herausforderung für den Arzt besteht darin, eine ganze Reihe von vital gefährdenden Erkrankungen von weniger dringlichen Beschwerdeursachen abzugrenzen. Auch extraabdominale Differenzialdiagnosen sind in Betracht zu ziehen.


Abdominal pain is one of the most common complaints that lead to an emergency department visit. Depending on the interpretation of the definition, 20–40 % of these patients present with an acute abdomen. This term summarizes a variety of diseases that often occur in the abdominal cavity, mostly acute, and can be accompanied by symptoms such as nausea and vomiting. The challenge for the physician is to differentiate a whole range of vital diseases from less urgent causes of complaints. Extra-abdominal differential diagnoses should also be considered. Initial diagnosis often requires a great deal of clinical experience.

The targeted medical history and clinical assessment together with the selection of the appropriate technical investigation play a central role. The goal must be to move from symptom-based to causal therapy as quickly as possible and to clarify whether a patient needs to be referred to an emergency operation or whether there is time for further differential diagnostic measures. The prognosis of the acute abdomen often depends on the time latency until the definitive therapy is initiated. Rapid and determined action by the experienced initial examiner are important prerequisites for a favorable course of the disease process.

Publication History

Publication Date:
20 October 2020 (online)

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany