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Last reviewed: 15 Mar 2025
Last updated: 26 Mar 2025

Summary

Definition

History and exam

Key diagnostic factors

  • abdominal pain
  • constipation/failure to pass flatus or stool
  • vomiting
  • abdominal distention
  • abdominal tenderness
  • peritonitis
  • presence of risk factors
  • palpable abdominal mass

Other diagnostic factors

  • nausea
  • fever
  • tachycardia
  • tachypnea
  • severe lethargy
  • hypotension
  • diarrhea
  • groin swelling

Risk factors

  • previous abdominal surgery
  • intestinal malignancy
  • malrotation
  • Crohn disease
  • hernia
  • intussusception
  • volvulus
  • intestinal atresia
  • appendicitis
  • foreign body ingestion

Diagnostic tests

1st tests to order

  • abdominal CT scan
  • CBC
  • BUN
  • electrolyte panel

Tests to consider

  • abdominal x-rays
  • water-soluble contrast study
  • laparotomy/laparoscopy
  • abdominal ultrasound
  • abdominal MRI

Treatment algorithm

Contributors

Expert advisers

Adrian Maung, MD, MBA, FACS, FCCM

Associate Professor of Surgery

Division of General Surgery, Trauma and Surgical Critical Care

Department of Surgery

Yale School of Medicine

New Haven

CT

Disclosures

AM declares that he has no competing interests.

Acknowledgements

Dr Adrian Maung would like to gratefully acknowledge Dr John T. Jenkins, Dr Edward T. Pring, Dr George Malietzis, Dr Frances J. McNicol, and Dr David J. Hackam, previous contributors to this topic.

Disclosures

JTJ , ETP, GM, FJM, and DJH declare that they have no competing interests.

Peer reviewers

Steven D. Wexner, MD, FACS, FRCS, FRCS (Ed)

Chief Academic Officer

Emeritus Chief of Staff (1997-2007)

Chairman Department of Colorectal Surgery

Professor of Surgery Ohio State University

Affiliate Professor Department of Surgery

Division of General Surgery

University of South Florida College of Medicine

Cleveland Clinic Florida

FL

Disclosures

SDW declares that he has no competing interests.

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