Acute abdomen...when suspected...upon clinical examination and history...get bloods----> fbc,CRP,buse creat,coag, cxr erect ----> nbm ----> speak to radiology for an urgent cect abdo ----> speak to surgical colleague for a review ----> review the cect and discuss with surgical for further management if it's a perf appendix/ perf viscus/ intrabdominal collection ---->monitor lactate