Objective  To analyze the causes of negative results of laparotomy for acute abdomen, and to propose strategies for the prevention of unnecessary laparotomy.

  Methods  We reviewed the medical records of 27 cases with negative findings in laparotomy for acute abdomen in Peking Union Medical College Hospital from January 1997 to December 2010, classifying the causes of negative laparotomy results.

  Results  In the 27 cases of acute abdomen, 6 had primary peritonitis, 6 rupture of corpus luteum, 4 acute pelvic inflammation, 3 paralytic intestinal obstruction, 3 autoimmune disease, 1 organic phosphorus poisoning, 1 acute myocardial infarction, and 3 were of unknown causes. The main reasons for negative laparotomy results were:inadequate medical history taking (6 cases, 22%), inaccurate physical examinations (3 cases, 11%), and lack of necessary laboratory tests (6 cases, 22%).

  Conclusions  Adequate medical history taking, accurate physical examination, and necessary laboratory tests constitute the key of preventing the occurrence of negative results of laparotomy for acute abdomen.