A comprehensive study on acute non-traumatic abdominal emergencies (original) (raw)
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https://www.ijhsr.org/IJHSR\_Vol.7\_Issue.5\_May2017/IJHSR\_Abstract.03.html, 2017
Abdominal pain is one of the most common emergency presenting to emergency department(ED). It poses a diagnostic challenge for the emergency physicians as the causes are numerous, ranging from benign to life threatening conditions. Emergency physician must consider multiple diagnoses, especially those life-threatening conditions that require timely intervention to limit morbidity and mortality. This prospective observational study was conducted in a large ED of a tertiary care center in India. All patients older than 15 years and presenting with non-traumatic abdominal pain to the ED from July 2016 to December 2016 were included in study and their clinical profile, diagnosis were analysed. A total of 204 patients were included in the study. Almost half (52%) of the patients were in the age group of 15-30 years. 63% patients were male showing male predominance in our study. The onset of pain was sudden in 64% of patients. WBF scale was used to grade the severity of pain. WBF scale score of 1-4, 5-7 and 8-10 was seen in 50%, 36%and 14% of patients, respectively. Common types of pain included dull aching (49%) and colicky (34%). 39% patients reported lower abdominal pain, while 21% had upper abdominal location. The pain was generalized in 40% of patients. The majority of patients (80%) did not have any radiation of the pain. The groin, back and shoulder were the common sites of radiating pain in 11%, 07% and 02%, respectively. Common associated symptoms included nausea (56%), vomiting (42%), urinary symptoms (18%), and loss of appetite (13%).Out of total 204 patients 46% were admitted for further workup and management while 52% were discharged from emergency department while 02% of patients took discharge at request. The final diagnosis at discharge was grouped as follows: Surgical (32%), gastrointestinal (24%), urinary tract related (29%), obstetrics and gynaecology related (3%) and nonspecific diagnosis (12%). The most common reasons for ED visits due to abdominal pain were ureteric colic (22%), acute gastroenteritis (11%), acid peptic disease (11%), UTI (7%), hollow viscus perforation (08%) and acute appendicitis (07%).
Acute Appendicitis and Its Management: A Hospital Based Study
https://www.ijrrjournal.com/IJRR\_Vol.8\_Issue.10\_Oct2021/IJRR-Abstract045.html, 2021
Background: Acute appendicitis is the most common acute surgical condition of the abdomen, which if complicated by perforation or peritonitis has high morbidity and mortality. Aim: The aim of this study is to analyze the presentation, diagnosis and management of acute appendicitis along with the role of conservative management in uncomplicated cases. Materials and Methods: This study was conducted in Govt. Medical College Jammu over a period of one year w.e.f. September 2017 to August 2018 and included 120 patients. Diagnosis in the suspected patients was based on history, clinical examination coupled with laboratory investigations and imaging modalities like ultrasound/ CT Scan wherever required. Results: 120 patients of acute appendicitis were treated over the period of one year at our center. Abdominal pain was the most common and constant presentation seen in 112 patients followed by vomiting (82), history of fever (60), history of constipation and distension (20) and another 12 had history of diarrhoea. Six patients (5%) responded favorably to conservative management. Conclusion: Acute appendicitis is a common surgical emergency requiring detailed history and meticulous examination coupled with X-ray and ultrasonography for diagnosis. Appendectomy is the standard procedure of choice and wherever feasible laparoscopic appendectomy offers the advantage of less pain, short hospital stay, earlier return to work and overall cost.
Management of acute abdomen : Study of 110 cases
2016
Background: The term acute abdomen designates symptoms and signs of intraabdominal diseases usually treated best by surgical operation. Many diseases, some of which do not require surgical treatment, produce abdominal pain, so the evaluation of patients with abdominal pain must be methodical and careful. The proper management of patients with acute abdominal pain requires a timely decision about the need for surgical operation. The term “acute abdomen” should never be equated with the invariable need for operation. The abdomen has been referred to as Pandora’s magic box. Very often an accurate diagnosis cannot be made without surgery and many wonders are revealed on opening the abdomen. So it is often the last court of appeal in investigating abdominal cases. The general rule can be laid down that the majority of severe abdominal pains that ensue in patients who have been previously well, and that last as long as six hours, are caused by conditions of surgical import. Materials and ...
INRODUCTION: Acute pain abdomen which may occur due to many causes like gastrointestinal, urological, gynaecological, metabolic, psychogenic, aortic dissection etc. Acute pain abdomen accounts for 5% to 10% of emergency admissions. AIMS AND OBJECTIVES: To study the causes of non traumatic acute pain abdomen. MATERIALS AND METHODS: 200 patients presenting with non traumatic acute pain abdomen were included in this cross sectional observational study. Etiology of pain abdomen was searched with help of appropriate and proper clinical, laboratory and radiological investigations. RESULTS: Among the 200 patients enrolled, acute cholecystitis was the most common cause of acute non traumatic pain abdomen. CONCLUSION: Prompt diagnosis and proper management of acute pain abdomen is required to reduce the mortality and morbidity associated with underlying cause.
Clinical study, diagnostic aids and management of acute abdomen
International Journal of Current Research in Biology and Medicine
Background: Evaluation of the emergency department(ED) patient with acute abdomen is sometimes difficult. Various factors can obscure the presentation, delaying or preventing the correct diagnosis, with subsequent adverse patient outcomes. Clinicians must consider multiple diagnoses, especially those life-threatening conditions that require timely intervention to limit morbidity and mortality. The term acute abdomen is constantly applied to such cases that signify the urgent need for prompt diagnosis and active treatment. Objective: This study is designed to examine the present state of diagnosis and management of acute abdomen and to develop evidence based guidelines for the diagnostic pathway and management of acute abdomen. Result: Our study showed that acute cholecystitis was the most common cause (29%) in patients presenting with acute abdomen followed by perforation peritonitis (25%). Pain and vomiting (49%) was the most common complaint followed by distension (44%). Ultrasound is the most sensitive and most commonly used diagnostic aid in acute abdomen. Majority of patients(73%) required surgical intervention. Conclusion: Abdominal pain is a common presenting complaint in the ED and clinicians must consider multiple diagnoses, especially in those cases that require immediate intervention in order to limit morbidity and mortality.
Revista Española de Enfermedades Digestivas, 2009
Objective: to determine the real importance of anamnesis, physical examination, and various tests in the assessment of acute abdominal pain. Methods: a retrospective observational study with patients complaining of abdominal pain at the Emergency Department, Altiplano Health Area (Murcia) was performed. In our study we considered the following variables: socio-demographic data, history of previous surgery, symptoms, place and type of pain. Imaging tests were labeled as positive, negative, or inconclusive for assumed diagnoses, which were retrospectively assessed by an external radiologist who was unaware of the patient's final diagnosis. Results: our study includes 292 patients with a mean age of 45.49 years; 56.8% of these patients were women. Regarding the frequency of the different acute abdomen diagnoses, appendicitis was the main cause (approx. 25%), followed by cholecystitis (10%). We found a significant diagnostic correlation between pain location in the right hypochondrium (RHC) and a diagnosis with cholecystitis. This location was also significant for acute appendicitis (up to 74%). Regarding clinical signs, we only observed a significant correlation between fever and viscera perforation, and between Murphy's sign and cholecystitis. Sensitivity and specificity found in relation to the psoas sign were similar to those seen in other series, 16 and 95% respectively, and slightly lower than the Blumberg or rebound sign, which we found to be around 50 and 23%, respectively. Conclusions: a) anamnesis and physical examination offer limited accuracy when assessing acute abdomen; b) ultrasound scans offer a low diagnostic agreement index for appendicitis; and c) laparoscopy may prove useful for diagnosis, and is also a possible treatment for acute abdominal pain despite its low diagnostic efficiency.
Acute appendicitis: Epidemiology, treatment and outcomes- analysis of 16544 consecutive cases
World journal of gastrointestinal surgery, 2016
To investigate the epidemiology, treatment and outcomes of acute appendicitis (AA) in a large population study. This is a retrospective cohort study derived from the administrative dataset of the Bergamo district healthcare system (more than 1 million inhabitants) from 1997 to 2013. Data about treatment, surgery, length of stay were collected. Moreover for each patients were registered data about relapse of appendicitis and hospital admission due to intestinal obstruction. From 1997 to 2013 in the Bergamo district we collected 16544 cases of AA, with a crude incidence rate of 89/100000 inhabitants per year; mean age was 24.51 ± 16.17, 54.7% were male and the mean Charlson's comorbidity index was 0.32 ± 0.92. Mortality was < 0.0001%. Appendectomy was performed in 94.7% of the patients and the mean length of stay was 5.08 ± 2.88 d; the cumulative hospital stay was 5.19 ± 3.36 d and 1.2% of patients had at least one further hospitalization due intestinal occlusion. Laparoscopic ...
EVALUATION AND MANAGEMENT OF ACUTE ABDOMINAL PAIN IN THE EMERGENCY DEPARTMENTS
Aim of Study: At some points, evaluation of patients become extremely difficult when they present with acute abdominal pain issues with no other prominent disorder. Delay in the presentation and diagnosis of the issue can obscure the results and leave adverse outcomes for the patient. Multiple diagnosis techniques must be considered by clinicians, especially when the condition is life threatening and require immediate attention to limit mortality and morbidity. This article encapsulates the general information regarding abdominal pain, and some important steps of modus operandi are discussed to minimize the uncertainty of the case. Additionally, the approach for unstable patients with acute abdominal pain has also been discussed here. Evaluation of the emergency department patient with acute abdominal pain is sometimes difficult. Various factors can obscure the presentation, delaying or preventing the correct diagnosis, with subsequent adverse patient outcomes. Clinicians must consider multiple diagnoses, especially those life-threatening conditions that require timely intervention to limit morbidity and mortality. This article will review general information on abdominal pain and discuss the clinical approach by review of the history and the physical examination. Additionally, this article will discuss the approach to unstable patients with abdominal pain. Evaluation of the emergency department patient with acute abdominal pain is sometimes difficult. Various factors can obscure the presentation, delaying or preventing the correct diagnosis, with subsequent adverse patient outcomes. Clinicians must consider multiple diagnoses, especially those life-threatening conditions that require timely intervention to limit morbidity and mortality. This article will review general information on abdominal pain and discuss the clinical approach by review of the history and the physical examination. Additionally, this article will discuss the approach to unstable patients with abdominal pain.
IP innovative publication pvt. ltd, 2019
Introduction: Acute abdomen is a very common problem in emergency department. Aims and Objectives: This study aims to find out the clinical and epidemiology profile of acute abdominal pain among patients attending emergency department of Santosh Medical College Ghaziabad. Materials and Methods: A tertiary care hospital based, cross-sectional study was conducted from January 2018-April 2019 2018, among patients presenting with acute abdominal pain to Santosh Medical College Ghaziabad, India. Data was entered on a standard data collection sheet after obtaining a written informed consent. Results: Out of 1200 patients admitted via the Emergency Department at the Hospital, 200 (16.6%) were admitted with atraumatic acute abdominal pain. Out of 200, 120(60%) were due to Surgical causes and 80 due to non-surgical causes. Most consistent symptom and sign were pain abdomen and abdominal tenderness respectively. Acute cholecystitis was the most common etiology of acute abdominal pain (35.8% cases), followed by, Renal Stones (30.5%), Acute Appendicitis (17.5%) and Intestinal Obstruction (16.67%) respectively. Conclusion: About 16.60% of all emergency admissions were due to acute abdominal pain and about 60.0% of all atraumatic acute abdominal pain was due to surgical cause. Acute cholecystitis was the most common cause of surgical abdominal pain.