What condition does not generally cause acute abdominal pain?

Cholelithiasis, or gallstones, typically does not cause acute abdominal pain in the way the other conditions listed do. While gallstones can lead to episodes of pain, particularly when they obstruct the bile ducts, this pain is often episodic and can manifest as biliary colic. It is typically associated with meals and may not present as an acute, sudden, and severe abdominal pain as seen in conditions like appendicitis or diverticulitis, where immediate medical attention is often necessary due to the potential for complications such as perforation.

In contrast, gastritis, appendicitis, and diverticulitis generally present with acute and severe abdominal pain. Gastritis can cause abdominal pain, especially if there is inflammation and irritation in the stomach lining. Appendicitis usually presents with a sudden, severe pain in the right lower quadrant, often accompanied by other symptoms such as fever and nausea. Diverticulitis typically results in significant left lower quadrant pain, which can be quite severe, especially if there is inflammation or infection involved.

This distinction in how these conditions present helps clarify why cholelithiasis is the answer that does not fit the pattern of causing acute abdominal pain.