Acute Abdomen in Diabetic Patients - What Should We Do?

Diabetes mellitus is a well-known metabolic disease, with an increasing incidence around the world. The histological and clinical features of many diseases, including acute abdomen, are significantly modified in diabetic patients and thus the therapeutic approach should be carefully considered. Two main errors are possible, and they may equally cause a poor outcome of the patient: a delayed surgical procedure in peritonitis, due to its atypical clinical and biological expression, or an un-necessary laparotomy in a diabetic patient with acidosis, which transforms an already severe condition into a worse one. Therefore, in order to avoid confusion of diagnosis and treatment, the extended use of advanced imaging techniques (CT, MRI) or even a laparoscopic inspection of the peritoneal cavity may proove justified in many cases.