Which condition would most likely present with acute abdominal pain associated with neurovisceral symptoms?

Acute intermittent porphyria is associated with acute abdominal pain as well as neurovisceral symptoms. This condition is part of a group of disorders known as porphyrias, which arise due to deficiencies in enzymes involved in the heme biosynthesis pathway.

In acute intermittent porphyria, the deficiency of porphobilinogen deaminase leads to the accumulation of porphyrin precursors, which can cause symptoms that manifest acutely. Patients often experience severe abdominal pain, which is thought to be due to visceral nerve involvement and the effect of the accumulated substances on the autonomic nervous system. Additionally, neurovisceral symptoms such as anxiety, confusion, and peripheral neuropathy can occur.

Other options present conditions that do not typically manifest with the same combination of acute abdominal pain and neurovisceral symptoms. For example, porphyria cutanea tarda primarily presents with skin manifestations rather than acute abdominal pain. Gilbert's disease is a genetic condition associated with mild hyperbilirubinemia and is usually asymptomatic. Lead poisoning can cause abdominal pain and neurological symptoms, but it typically presents with chronic symptoms and the abdominal pain may not be as severe or as directly related to neurovisceral involvement as seen in acute intermittent porphyria.