Which finding would be more indicative of an acute abdomen during a physical examination?

Absent bowel sounds are particularly indicative of an acute abdomen due to their association with peritoneal irritation, obstruction, or significant underlying pathological conditions that can compromise normal bowel function. In cases of acute abdomen, such as perforation or severe conditions requiring surgical intervention, the absence of bowel sounds can signify a lack of gastrointestinal activity as the body responds to inflammation or irritation in the abdominal cavity.

A finding of guarding is also significant in identifying abdominal issues, as it indicates voluntary muscle contraction in response to pain; while it is often seen in cases of an acute abdomen, it may not be as definitive as absent bowel sounds in the context of an acute condition. Rebound tenderness suggests irritation of the peritoneum and is often associated with conditions like appendicitis, but it still may not provide the same level of indication for acute pathology as absent bowel sounds. Severe tenderness can indicate serious issues as well, but without the context of bowel activity, it doesn't provide the same clarity regarding the acute state of the abdomen as the complete absence of bowel sounds does.