Abdominal Pain: Warning Signs and New Brazilian Guidelines for Obstructive Acute Abdomen

Abdominal pain is one of the most frequent complaints in clinics and emergency departments. While many episodes are harmless and resolve quickly, persistent, severe or nighttime pain, especially when accompanied by fever, vomiting, intense diarrhea, loss of appetite or other systemic symptoms, may signal a serious underlying condition that requires prompt medical evaluation.

In Brazil, the latest national guidelines for obstructive acute abdomen recommend a more conservative initial approach. Early use of oral water‑soluble contrast is advised to locate the obstruction and may aid treatment in partial blockages. Patients should be monitored clinically and with CT imaging for 24–48 hours before deciding on surgery, unless there are clear signs of tissue compromise. These updates aim to reduce unnecessary operations while ensuring timely intervention for those who need it.