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Volume 27 Number 1

The Acute Abdomen—a Rapid Review:

By Frank Hubbell, DO


Abdominal pain can be one of the most difficult disorders to pin down and make an accurate diagnosis. We have done extensive articles in the past regarding the acute abdomen, but we felt it was time to do a condensed review of the topic.


There are approximately 2000 medical conditions that can cause abdominal pain. The intention of this article is to do a quick review of a systematic way to enable you to sort out the myriad of problems that can cause an acute abdomen, how to determine the severity of the problem, and finally, how to treat the problem.




Etiologies of Abdominal Pain:

What are the various underlying causes of abdominal pain?

Constipation – by far the most common cause of abdominal pain and discomfort

Food Poisoning – also very common, associated with vomiting and diarrhea

Infection – peritonitis from an acute appendicitis or cholecystitis (infected gallbladder)

Bleeding or Perforations – a bleeding ulcer or diverticulitis

Ruptures – acute aortic aneurysm, ruptured appendix, or gallbladder

Obstructions – gallstones, kidney stones, or intestinal blockage

Gynecological – menstrual cramps or ectopic pregnancy

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Hymenolepidiae tapeworms:

Hymenolepidiae tapeworms:

September/October 2011 ISSN-1059-6518 Volume 24 Number 5



By Frank Hubbell, DO

This is the scientific taxomony for the Class Cestoda – tapeworms. In previous issues of the WMN we have discussed the Taenia and Echinococcus tapeworms. In this edition we will explore the Hymenolepidiae tapeworms.

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Acute Abdominal Emergencies

…You begin to review in your mind all the possibilities, beginning by asking, “What do we know?” We know that she is a 20-year-old female, in excellent health, who is now complaining of nausea, diarrhea, and abdominal pain for the past 6 hours, all of which seem to be getting worse. There are so many options: she could be dehydrated, have food poisoning, have viral gastroenteritis, be pregnant, be constipated, or maybe even have an acute appendicitis….


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The Facts Regarding Abdominal Trauma:


– Abdominal trauma has two primary causes: blunt trauma and penetrating trauma.

– Blunt trauma occurs from a direct blow to the abdomen, causing compression or concussion of the internal organs.

– Deceleration injuries cause a shearing or stretching of the internal supporting tissues – a tug-of-war, so to speak, between a fixed organ and the mobile support tissues.

– Blunt abdominal trauma is the leading cause of morbidity (injury) and mortality (death) in all age groups.

– The mechanism of injury (MOI) that causes blunt trauma frequently has other potentially serious injuries as well. Rarely is blunt trauma to the abdomen an isolated injury.

– The liver and the spleen are the most frequently injured organs followed by the small and large intestine.

– 8% of trauma patients have an abdominal injury.

– 9% of abdominal trauma patients die from the abdominal injury.



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