When to refer

• All cases of acute abdominal pain where urgent surgical intervention is required; special urgency and early diagnosis is important with:

o ruptured ectopic pregnancy o ruptured abdominal aortic aneurysm o mesenteric artery occlusion o ruptured viscus o perforated peptic ulcer o strangulated obstructed bowel o intussusception

• All cases where the diagnosis is not apparent

• All cases where surgery is necessary

• Medical causes such as diabetic ketoacidosis and porphyria

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Body Language

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