UrgentEmergency Guide
Abdominal pain: Red Flags & Emergency Signs
Sudden severe abdominal pain in anyone over 50, or with haemodynamic instability, must be assumed to be aortic aneurysm rupture or mesenteric ischaemia until proven otherwise.
🚨 Call 999 / 112 Immediately
- ⚠Severe, tearing abdominal pain with collapse in an older patient — ruptured AAA (immediate surgery)
- ⚠Abdominal pain with rigidity and board-like abdomen — peritonitis (perforated viscus)
- ⚠Abdominal pain with haemodynamic instability in a woman of childbearing age — ruptured ectopic pregnancy
- ⚠Abdominal pain with absolute constipation and distension — complete bowel obstruction
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- •Right iliac fossa pain migrating from periumbilical region with fever — appendicitis
- •Severe epigastric pain radiating to the back, worse supine, with vomiting — acute pancreatitis
- •Abdominal pain in a child with intermittent screaming, vomiting, and currant-jelly stools — intussusception
High-Risk Combinations
When abdominal pain occurs together with any of these symptoms, urgency increases significantly:
Conditions to Rule Out Urgently
Ruptured Aortic Aneurysmemergency
CT aortogram; vascular surgery; if shocked = direct to theatre
Acute Appendicitisurgent
Alvarado score; USS/CT; surgery within 24 hours
Ruptured Ectopic Pregnancyemergency
βhCG + transvaginal USS; surgical emergency
Acute Pancreatitisurgent
Amylase/lipase; CT; Glasgow score for severity
Mesenteric Ischaemiaemergency
CT angiography; lactate; early surgical intervention
Condition Authority Pages
Differential diagnosis analyses:
When to Call Emergency Services
- →Severe abdominal pain with collapse or fainting
- →Abdominal pain with rigid board-like abdomen
- →Abdominal pain with heavy vaginal bleeding in pregnancy