Hi sorry! This was my first time posting and I didn't realize there were responses.
I work in palliative home care and I sent two patients with cancer (2 different occasions) to the palliative tertiary unit in the hospital. They both had abdomen pain that we couldn't manage at home. When they arrived in the hospital, the doctor suspected there was a perforation somewhere (but in the end both chose comfort measures). The doctor felt because it happened twice, I should have better assessment skills to recognize these were emergency situations rather than something less emergent like uncontrolled pain... if that makes sense.
I did end up asking for help today at palliative rounds to differentiate. Another doctor explained it to me that for an acute abdomen pain, it's a term they use for emergency situations that require surgical intervention (eg- perforated viscus). She said the patients normally describe the pain as something different from their "normal" cancer pain, client does not want to be moved/touched due to pain, the abdomen would be firm, distended and bounces back when you palpate, decreased/no bowel sounds, and it's a rapid change from their baseline (eg within hours).
In the end, the palliative team said I did the right thing sending them to the hospital and the two cases were complex (isn't that always the case hah) that masked the acute abdomen pain (eg ascites, pain management issues with their "normal" cancer pain, etc).
Thank you for your help!