Background & Objective : One percent of emergency ward receptions are acute abdomen problems. Gynecological causes include 20%of them. Relation between physiology of women and abdominal pains challenges diagnosis. Clinical diagnosis in these cases have no substitution and studies about accuracy of diagnosis helps to correct future clinical diagnosis .

  Methods : A cross-sectional study conducted over 148 women whom admitted for acute abdomen causes and operation in Urmia Kosar Hospital during 1375-79. Data of history and Para clinical and also pre and post operation diagnosis Collected by related questionnaire and interpreted .

  Results : Ectopic pregnancy (39.9%), ruptured ovarian cyst (23.6%), ovarian cyst torsion(18.2 % ), abdomen masses unrelated to gynecological system (4.1%), were respectively common causes. Two cases were normal. Five appendicitis cases diagnosed after laparatomy. We observed 76% similarity of diagnosis before and after laparatomy, which coordinated with other studies. Ectopic pregnancy with 66 cases of diagnosis before and 53cases confirmation after operation was related to over diagnosis and 22 cases of ovarian cyst ruptures before operation and 36 cases of them after operation were related to under diagnosis .

  Conclusion : Considering the results, common causes of acute abdomen incur most frequent misdiagnoses. So keeping in mind that sometimes common cases appear atypically and on time using of paraclinic measures can help the surgeon to diagnose correctly before laparatomy .