Non Traumatic Acute Abdominal pain (100 days study in Emergency Department)

Background: Abdominal symptoms are possibly the most frequent of all symptoms encountered in surgical practice. Pain is the most common of all abdominal symptoms. Causes of acute abdominal pain include both medical and surgical. Most symptoms arise from intra-abdominal organs or systems while some may originate extra abdominally and are then referred to the abdomen. Medical causes of abdominal pain are encountered more frequently. Objective: To study the causes of acute abdominal pain in patients attending emergency department in Al- Imamain Al- Kadhimain Medical City. Type of the study: A prospective cross sectional study Methods: The patients attending Emergency Department in Al- Imamain Al- Kadhimain Medical City over the period from April-2014 to April 2016. There was a one day call duty per week managed by the same surgical team (total one hundred days study). Onlypatients above 12 years old with acute non-traumatic abdominal pain were included in this study. Results: The total number was 1217 patients over hundred days study. Their age ranges from 12-83 years; average age was 36.18 ±17 year. There was slight female predominance, 638 (52.42%) female patients and 579 (47.58%) male patients. The most common cause of abdominal pain was acute appendicitis 252 (20.70%), followed by ureteric colic 251 (20.62%), and acute cholecystitis249 (20.46%). Conservative management was done for 836 (68.69%) patients, while operative management done for 379 (31.14%) patients. Postoperative mortality was 8 (2.11%) patients.Medical causes of acute abdominal pain were found in 48 (5.74%) patients. Conclusion: Not all the patients attending surgical emergency department needs operations. Causes of acute abdominal pain include both medical and surgical diseases, some of the medical diseases are very serious like acute viral hepatitis, myocardial infarction , and diabetic ketoacidosis; and should not submit those patients to unnecessary operations with serious and may be fatal postoperative complications. General urine examination is a must in all patients with acute abdominal pain. Electrocardiography (ECG) may be needed in old patients.

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The Diagnostic Values of Ischemia-Modified Albumin in Patients with Acute Abdominal Pain and Its Role in Differentiating Acute Abdomen

Emergency Medicine International ◽

10.1155/2020/7925975 ◽

2020 ◽

Vol 2020 ◽

pp. 1-7

Author(s):

Selman Yeniocak ◽

Fatma Saraç ◽

Mustafa Yazıcıoğlu ◽

Nadiye Karabulut ◽

Akın Ünal ◽

...

Keyword(s):

Emergency Department ◽

Abdominal Pain ◽

Acute Appendicitis ◽

Acute Abdominal Pain ◽

Diagnostic Value ◽

Cross Sectional Study ◽

Control Group ◽

Cross Sectional ◽

Ischemia Modified Albumin ◽

The Mean

Aim. The aim of this study was to evaluate the diagnostic value of serum ischemia-modified albumin (IMA) levels in patients presenting to the emergency department with acute abdominal pain and its use in differentiating acute surgical abdomen. Methods. This single-center prospective cross-sectional study included 334 adult patients who presented to the emergency department. These consisted of 194 patients (Group 1) with nontraumatic abdominal pain commencing in the preceding week, who were definitely diagnosed and either hospitalized in a specific department or planned for discharge, and a control group of 140 patients (Group 2). Results. The mean IMA value of the patients diagnosed with acute appendicitis was statistically significantly higher than that of the control group. The mean IMA value of the patients diagnosed with acute appendicitis, ovarian pathologies, and gastritis-peptic ulcer was statistically significantly higher than that of the nonspecific abdominal pain group. Conclusion. Serum IMA levels can be used as a diagnostic marker in patients with acute appendicitis. Furthermore, serum IMA levels in patients presenting to the emergency department with abdominal pain may be indicative of patients requiring surgery or of complicated cases, particularly in terms of acute appendicitis and ovarian pathologies.

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Analgesia of acute abdominal pain in the Emergency Department

Health & Research Journal ◽

10.12681/healthresj.20999 ◽

2019 ◽

Vol 5 (3) ◽

pp. 86

Author(s):

Panteleimon Kalaronis ◽

Antonia Kalogianni ◽

Martha Kelesi ◽

Eytichia Evagelidou ◽

Ioulia-Maria Mpalla ◽

...

Keyword(s):

Emergency Department ◽

Abdominal Pain ◽

Acute Abdominal Pain ◽

Cross Sectional Study ◽

Cross Sectional ◽

International Guidelines ◽

Closed Type ◽

Number Of Patients ◽

The Mean ◽

First Time

Introduction: Pain accounts for 40% of all patients admitted to the Emergency Department (ED). The most common cause of pain is abdominal pain, which accounts for 8%. In contrast to the international guidelines, pain is under-treated making the phenomenon of oligoanalgesia apparent.Aim: The purpose of this study was to explore the incidence of analgesia in patients admitted to the ED suffering from acute abdominal pain. Material and Method: This is a descriptive cross-sectional study. The studied sample consisted of 197 patients, who admitted to the ED of a General Hospital of Athens, Greece with reported symptom: acute abdominal pain. For data collection, a special designed form of closed-type questionnaires was used. Data analysis was performed by using the Statistic Package for Social Sciences (SPSS) statistical packet ver.19.Results: Out of the total number of patients admitted to ED with reported abdominal pain, 74.6% received analgesia and the mean time of analgesia administration during ED admission was 46.43 minutes. The mean pain intensity at the first time point measurement was 7.16 and at the second one was 4.04, according to pain recording scale (0-10 scale). Non-opioid anti-inflammatories (52.3%), non-steroidal analgesics (22.8%) and opioids (9.1%) were mainly administered patients during their ED stayConclusions: Despite the published international guidelines which refer to analgesia time and type, pain and especially abdominal pain, is under-treated. The key to tackling oligoanalgesia is to educate health professionals.

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Do Patients Know Their Physicians' Names and Their Specialties? Results from King Abdulaziz Medical City, Riyadh, Saudi Arabia

Saudi Journal of Internal Medicine ◽

10.32790/sjim.2014.4.1.3 ◽

2014 ◽

Vol 4 (1) ◽

pp. 9-13

Author(s):

Salih Binsalih ◽

Omar Al Harthi ◽

Mohammad Qahtani ◽

Abdullah Al Sayyari

Keyword(s):

Emergency Department ◽

Saudi Arabia ◽

Length Of Hospital Stay ◽

Female Gender ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Medical City ◽

Arabic And English ◽

Medical Wards

Objective: To determine if inpatients in medical wards are aware who their most responsible physician (MRP) is and what is the nature of his/her specialty and if this awareness is influenced by age, sex, method of admission and the length of hospital stay. Methods: A cross-sectional study conducted at King Abdulaziz Medical City, Riyadh. Results: One hundred patients completed the survey from 7 different wards. 66% were male and two-thirds of the patients were over the age of 60 years, and 55% were inpatients for more than 10 days. Overall respondents, 43% knew the name of their MRP whereas 57% did not. Conclusion: Reduced awareness was more often observed in female gender, older age and being admitted through Emergency Department. It's recommended that MRPs' names on signboards be written in Arabic and English in all wards.

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The Diagnostic Process for the Evaluation of Acute Abdominal Pain by Resident Trainees in Japan: A Cross-sectional Study

Internal Medicine ◽

10.2169/internalmedicine.3526-19 ◽

2020 ◽

Vol 59 (10) ◽

pp. 1257-1265

Author(s):

Kaori Amari ◽

Norio Fukumori ◽

Keizo Anzai ◽

Shu-ichi Yamashita

Keyword(s):

Abdominal Pain ◽

Acute Abdominal Pain ◽

Cross Sectional Study ◽

Diagnostic Process ◽

Sectional Study ◽

Cross Sectional

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Accuracy of citrulline, I-FABP and d-lactate in the diagnosis of acute mesenteric ischemia

Scientific Reports ◽

10.1038/s41598-021-98012-w ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Alexandre Nuzzo ◽

Kevin Guedj ◽

Sonja Curac ◽

Claude Hercend ◽

Claude Bendavid ◽

...

Keyword(s):

Abdominal Pain ◽

Mesenteric Ischemia ◽

Acute Abdominal Pain ◽

Acute Mesenteric Ischemia ◽

Cross Sectional Study ◽

Diagnostic Study ◽

Cross Sectional ◽

Fatty Acid Binding ◽

Stroke Center ◽

New Biomarkers

AbstractEarly diagnosis of acute mesenteric ischemia (AMI) remains a clinical challenge, and no biomarker has been consistently validated. We aimed to assess the accuracy of three promising circulating biomarkers for diagnosing AMI—citrulline, intestinal fatty acid-binding protein (I-FABP), and d-lactate. A cross-sectional diagnostic study enrolled AMI patients admitted to the intestinal stroke center and controls with acute abdominal pain of another origin. We included 129 patients—50 AMI and 79 controls. Plasma citrulline concentrations were significantly lower in AMI patients compared to the controls [15.3 μmol/L (12.0–26.0) vs. 23.3 μmol/L (18.3–29.8), p = 0.001]. However, the area under the receiver operating curves (AUROC) for the diagnosis of AMI by Citrulline was low: 0.68 (95% confidence interval = 0.58–0.78). No statistical difference was found in plasma I-FABP and plasma d-lactate concentrations between the AMI and control groups, with an AUROC of 0.44, and 0.40, respectively. In this large cross-sectional study, citrulline, I-FABP, and d-lactate failed to differentiate patients with AMI from patients with acute abdominal pain of another origin. Further research should focus on the discovery of new biomarkers.

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Do Patients Know Their Physicians' Names and Their Specialties? Results from King Abdulaziz Medical City, Riyadh, Saudi Arabia

Saudi Journal of Internal Medicine ◽

10.32790/sjim.4.1.3 ◽

2014 ◽

Vol 4 (1) ◽

pp. 9-13

Author(s):

Salih Binsalih ◽

Omar Al Harthi ◽

Mohammad Qahtani ◽

Abdullah Al Sayyari

Keyword(s):

Emergency Department ◽

Saudi Arabia ◽

Length Of Hospital Stay ◽

Female Gender ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Medical City ◽

Arabic And English ◽

Medical Wards

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Epidemiology of acute abdominal pain: a cross-sectional study in a tertiary care hospital of Eastern India

International Surgery Journal ◽

10.18203/2349-2902.isj20190380 ◽

2019 ◽

Vol 6 (2) ◽

pp. 345 ◽

Cited By ~ 1

Author(s):

Jiwesh Kumar Thakur ◽

Rakesh Kumar

Keyword(s):

Abdominal Pain ◽

Acute Abdomen ◽

Acute Abdominal Pain ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Common Cause ◽

Medical College ◽

Pain Abdomen ◽

Life Threatening

Background: Acute abdomen is defined as “a spectrum of surgical, medical and gynecological conditions ranging from trivial to life threatening conditions, which require hospital admission, investigations and treatment. The possible causes of acute abdomen may range from benign and psychogenic pain to life threatening aortic dissection. This study aims to find out the etiological spectrum of surgical acute pain abdomen among patients attending emergency department of a medical college of Eastern India.Methods: An institution based, cross-sectional study was conducted from January- June 2018, among patients admitted with pain abdomen in IQ City Medical College and Narayna Hospital, Durgapur, West Bengal, India. Data were collected on the day of discharge, with the help of pre-tested, semi structured Schedule.Results: Total 8688 patients were admitted through emergency during data collection period. 1236 (14.2%) of them were admitted with complains of pain abdomen. Frequency of surgical and non-surgical pain abdomen was 6.0% and 8.2% respectively. Most consistent symptom and sign were pain abdomen and abdominal tenderness respectively. Most common cause of acute abdomen was acute appendicitis. It was present in 38.9% of cases followed by gall bladder pathology, renal/ ureteric colic, perforation peritonitis, intestinal obstruction, bowel ischemia in 21.0%, 14.2%, 13.7%, 7.8%, and 4.4% of cases respectively.Conclusions: About 15.0% of all emergency hospitalization is due to acute abdominal pain and about 40.0% of all acute abdominal pain was due to surgical causes. Most common cause of surgical acute abdomen was acute appendicitis.

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Electrolyte Abnormalities in Children Presenting with Acute Gastroenteritis

10.53350/pjmhs2115123361 ◽

2021 ◽

Vol 15 (12) ◽

pp. 3361-3363

Author(s):

Shahid Iqbal ◽

Raja Imtiaz Ahmed ◽

Muhammad Abdul Quddus ◽

Jahangir Zaib ◽

Manzoor Ali Khan ◽

...

Keyword(s):

Emergency Department ◽

Abdominal Pain ◽

Rural Areas ◽

Acute Gastroenteritis ◽

Cross Sectional Study ◽

The Other ◽

Sectional Study ◽

Cross Sectional ◽

Physical Examinations ◽

Electrolyte Abnormalities

Objective: To find out the frequency of electrolyte abnormalities among children with acute gastroenteritis. Study Design: A cross-sectional study. Place and Duration of the Study: The Department of Pediatrics, Sheikh Khalifa Bin Zayed Al Nahyan Hospital, Rawlakot from July 2020 to December 2020. Material and Methods: A total of 159 children of both genders aged between 1 month to 5 years and presenting with acute gastroenteritis at outpatient or emergency department were included. At the time of enrolment, clinical and physical examinations were performed while medical history and presenting complaints were recorded. Frequency of electrolyte abnormalities like hyponatremia, hypernatremia, hypokalemia and hyperkalemia were noted on a predesigned proforma. Results: In a total of 159 children, 86 (54.1%) were male. Mean age was noted to be 2.1+1.7 years while 69 (43.4%) children were aged between 1 to 3 years. Majority of the children, 104 (65.4%) belonged to rural areas of residence. Abdominal pain, vomiting and lethargy were the other most frequently observed presenting complaints noted among 91(57.2%), 60 (37.7%) and 51 (32.1%) children respectively. Among all children, mean serum sodium was noted to be 140+11.3 meq/L. Hyponatremia was found to be among 45 (28.3%) children while hypernatremia was present in 28 (17.6%) children with AGE. Mean serum potassium was calculated to be 4.2+3.7 mmol/L. Hypokalemia was found to be present among 28 (17.6%) children while hyperkalemia was noted to be among 10 (6.3%) children. Conclusion: Frequency of electrolyte abnormalities was found to be high among children with acute gastroenteritis. Timely identification and treatment of children presenting with acute gastroenteritis coupled with electrolyte abnormalities needs to be done to reduce the morbidity and mortality associated with these diseases. Keywords: Acute gastroenteritis, hypokalemia, hyperkalemia, hypernatremia, hyponatremia

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Cancer complaints: The profile of patients from the emergency department of a Brazilian oncology teaching hospital

F1000Research ◽

10.12688/f1000research.12632.1 ◽

2017 ◽

Vol 6 ◽

pp. 1919

Author(s):

Felipe Batalini ◽

Millena Gomes ◽

Fábio I ◽

Flávio Kuwae ◽

Giselle Macanhan ◽

...

Keyword(s):

Emergency Department ◽

Abdominal Pain ◽

Cross Sectional Study ◽

Primary Data ◽

Emergency Department Utilization ◽

Cross Sectional ◽

Primary Tumor Site ◽

Patients With Cancer ◽

Common Complaint ◽

Research And Education

Background: With the increase in prevalence of cancer in our society, we aim to clarify through primary data use what drives emergency department (ED) utilization among patients with cancer. Methods: This is a cross-sectional study. A direct survey was applied to cancer patients over 277 visits in 2015. Variables including chief complaint for current and last visit, frequency of visits, primary tumor site, and demographics were collected. Results: Pain was the most common complaint, responsible for 40% of visits, followed by constitutional symptoms (17%), and gastrointestinal complaints (11%). Abdominal pain was the single most noted pain type, with 18.4%, and had the highest rate of recurrence. It was followed by back pain, dyspnea, asthenia and fever, accounting for 8.5%, 8.5%, 8.1% and 7%, respectively. Cervical cancer represented 14.8% of patients, followed by breast (11.6%) and lung (7.6%) cancers. The majority of patients visited the emergency department less than once a month. Conclusion: The drivers of emergency department utilization among patients with cancer found through primary use data mostly confirm findings from larger studies with secondary use data. Our research underscores the burden of pain to patients with cancer, as it is the most common complaint leading to ED visits, and generally requires multiple visits. Abdominal pain was more likely to recur than other complaints. Patients could benefit from focused outpatient pain management, and from more research and education targeting cancer-related pain.

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