ADMISSION WITH ACUTE ABDOMEN: PRESENTATION, CONDITIONS IDENTIFIED AND MANAGEMENT OUTCOMES

Authors

  • Farzana Sabir Abbas Institute of Medical Sciences, Muzaffarabad-AJK
  • Shafaq Hanif Abbas Institute of Medical Sciences, Muzaffarabad-AJK
  • Fakhra Gardezi Abbas Institute of Medical Sciences, Muzaffarabad-AJK
  • Mohsina Saeed Abbas Institute of Medical Sciences, Muzaffarabad-AJK
  • Rashida Bibi Abbas Institute of Medical Sciences, Muzaffarabad-AJK
  • Sajjad Haider Abbas Institute of Medical Sciences, Muzaffarabad-AJK

Keywords:

Acute abdomen, Acute Appendicitis, Pancreatitis

Abstract

Background: Acute abdomen is one of the few conditions that require immediate surgical intervention most of the time. However, not all cases of acute abdomen need surgery. The objective was to determine the various presentations of acute abdomen and their management outcome in patients presenting with acute abdomen to AIMS, Muzaffarabad, Azad Jammu and Kashmir, Pakistan.  Methods: This prospective cohort study included individuals aged 18 and above who presented with abdominal pain lasting at least eight hours. Patients with trauma-induced abdominal pain were excluded. Consecutive non-probability sampling facilitated participant recruitment. Results: The majority (54%) were young, and males outnumbered females (62.61% and 37.39% respectively. Most patients presented within 8 hours of pain onset, diabetes and hypertension were the commonest comorbid. Mild pain was most common at presentation. In descending order, acute Appendicitis, acute cholecystitis, acute pancreatitis, intestinal obstruction, Peritonitis, UTIs, and gynaecological & obstetric conditions were the frequent reasons for abdominal pain. Conclusion: Recognizing the patterns of conditions that present as acute abdomen is essential for healthcare planners to develop effective treatment protocols, as incorrect management can lead to significant consequences.

Author Biographies

Farzana Sabir, Abbas Institute of Medical Sciences, Muzaffarabad-AJK

 

Shafaq Hanif, Abbas Institute of Medical Sciences, Muzaffarabad-AJK

 

Fakhra Gardezi, Abbas Institute of Medical Sciences, Muzaffarabad-AJK

 

Mohsina Saeed, Abbas Institute of Medical Sciences, Muzaffarabad-AJK

 

Rashida Bibi, Abbas Institute of Medical Sciences, Muzaffarabad-AJK

 

Sajjad Haider, Abbas Institute of Medical Sciences, Muzaffarabad-AJK

 

References

Agboola J, Olatoke S, Rahman G. Pattern and presentation of acute abdomen in a Nigerian teaching hospital. Niger Med J. 2014;55(3):266.

Criblez D. Acute abdominal pain--internist’s viewpoint. Praxis. 1997;86(6):203–8.

Kamin RA, Nowicki TA, Courtney DS, Powers RD. Pearls and pitfalls in the emergency department evaluation of abdominal pain. Emerg Med Clin North Am. 2003;21(1):61–72, vi.

Gajjar R, Gupta P, Verma D, Gouda B. Pattern and presentation of non-traumatic acute abdominal pain to an emergency department of a tertiary care hospital. Int J Health Sci Res. 2017;7(5):17–22.

Macaluso CR, McNamara RM. Evaluation and management of acute abdominal pain in the emergency department. Int J Gen Med. 2012;789–97.

Laméris W, Van Randen A, Van Es HW, van Heesewijk JP, van Ramshorst B, Bouma WH, et al. Imaging strategies for detection of urgent conditions in patients with acute abdominal pain: diagnostic accuracy study. Bmj. 2009;338.

de Burlet K, Lam A, Larsen P, Dennett E. Acute abdominal pain-changes in the way we assess it over a decade. N Z Med J Online. 2017;130(1463):39–44.

Selbst SM, Friedman MJ, Singh SB. Epidemiology and etiology of malpractice lawsuits involving children in US emergency departments and urgent care centers. Pediatr Emerg Care. 2005;21(3):165–9.

Kachalia A, Gandhi TK, Puopolo AL, Yoon C, Thomas EJ, Griffey R, et al. Missed and delayed diagnoses in the emergency department: a study of closed malpractice claims from 4 liability insurers. Ann Emerg Med. 2007;49(2):196–205.

Natesan S, Lee J, Volkamer H, Thoureen T. Evidence-based medicine approach to abdominal pain. Emerg Med Clin. 2016;34(2):165–90.

Rittenhouse DW, Chojnacki KA. Massive portal venous air and pneumatosis intestinalis associated with cocaine-induced mesenteric ischemia. J Gastrointest Surg Off J Soc Surg Aliment Tract. 2012;16(1):223–5.

Soon Y, Hardy RG. Acute abdomen. Surg Oxf. 2002;20(7):169–72.

Azam M, Chaudhary A. An etiological spectrum of mechanical intestinal obstruction: a study at Lahore garrison. Pak Armed Forced Med J. 2004;54(1):19–24.

Dang C, Aguilera P, Dang A, Salem L. Acute abdominal pain. Four classifications can guide assessment and management. Geriatr Basel Switz. 2002;57(3):30–2.

Laurell H, Hansson LE, Gunnarsson U. Acute abdominal pain among elderly patients. Gerontology. 2006;52(6):339–44.

Bashir MSM, Khade A, Borkar P, Saleem M, Lingaswamy V, Reddy D. A comparative study between different pain rating scales in patients of osteoarthritis. Indian J Physiol Pharmacol. 2013;57(2):205–8.

Powers RD, Guertler AT. Abdominal pain in the ED: stability and change over 20 years. Am J Emerg Med. 1995;13(3):301–3.

Abbas SM, Smithers T, Truter E. What clinical and laboratory parameters determine significant intra abdominal pathology for patients assessed in hospital with acute abdominal pain? World J Emerg Surg WJES. 2007;2:26.

Zahid M, Abdullah MT, PIMS I. Presentation and outcome of acute abdomen in a tertiary care unit. Ann Pak Inst Med Sci. 2011;7(3):137–41.

Ohene-Yeboah M. Acute surgical admissions for abdominal pain in adults in Kumasi, Ghana. ANZ J Surg. 2006;76(10):898–903.

Kachalia A, Gandhi TK, Puopolo AL, Yoon C, Thomas EJ, Griffey R, et al. Missed and delayed diagnoses in the emergency department: a study of closed malpractice claims from 4 liability insurers. Ann Emerg Med. 2007;49(2):196–205.

Selbst SM, Friedman MJ, Singh SB. Epidemiology and etiology of malpractice lawsuits involving children in US emergency departments and urgent care centers. Pediatr Emerg Care. 2005;21(3):165–9.

Dr F. Has misdiagnosis of appendicitis decreased over time? JAMA. 2001;286:1748–53.

Kumar R, Ray MS. Pattern of illnesses presenting as acute abdomen: surgical study in 118 patients. Int Surg J. 2021;8(6):1705–11.

Published

2024-04-17