scholarly journals Causes and Management of Acute Abdominal Pain in Children: A Review Article

2021 ◽  
pp. 14-22
Author(s):  
May Abdullah S. Alanazi ◽  
Abdulaziz Muslih Muhaylan Alsharari ◽  
Ibrahim Awadh R. Alanazi ◽  
Abdulaziz Mashan R. Alanazi
Keyword(s):  
Abdominal Pain ◽  
Emergency Room ◽  
Acute Abdominal Pain ◽  
Symptomatic Treatment ◽  
Review Article ◽  
Pain Site ◽  
Life Threatening ◽  
Laboratory Investigations ◽  
Surgical Conditions

Acute abdominal pain is one of the commonest prevalent grievances in children, and it frequently requires emergency room diagnosis and management. Abdominal pain in children differs with age, concomitant symptoms, and pain site. While most cases of acute abdominal embarrassment are self-limiting and benevolent, there are certain diseases that can be life-threatening and necessitate instant care, such as appendicitis, intussusception, or intestinal obstruction. To decide the cause of acute abdominal pain and recognize children with surgical conditions, scrupulous history taking and numerous physical checkups are mandatory.The most important and realistic first goal in the evaluation of acute AP is to distinguish between surgical and nonsurgical situations, which are further divided into urgent and non-urgent categories. A thorough history and physical examination, laboratory investigations to evaluate comorbidity, and imaging scans are usually used for these purposes. Management decisions should necessitate teamwork between the emergency room physician, a surgeon, and a radiologist. Consecutivereassessment and symptomatic treatment with hardworking follow-up are necessary for management as soon aspossible in urgent disorder.

Celiac artery aneurysm causing an acute abdomen

2021 ◽  
Vol 14 (4) ◽  
pp. e240533
Author(s):  
Rute Castelhano ◽  
Khine Myat Win ◽  
Sara Carty
Keyword(s):  
Abdominal Pain ◽  
Acute Abdominal Pain ◽  
Artery Aneurysm ◽  
Celiac Artery ◽  
Common Presentation ◽  
Accident And Emergency ◽  
Life Threatening ◽  
Celiac Artery Aneurysm ◽  
Accident And Emergency Department ◽  
Surgical Conditions

Abdominal pain is a very common presentation in the accident and emergency department. However, vasculitis is not the usual first differential diagnosis. This paper discusses a case of polyarteritis nodosa presenting with acute abdominal pain alone. Common surgical conditions were obviously considered, but they were not found to cause the patient’s problems. We describe how investigations led to this diagnosis discussed in detail in this paper. It is important to remember that prompt recognition of unusual life-threatening conditions can lead to timely intervention.

scholarly journals Endoscopic follow-up of cyanoacrylate obliteration of gastric varices

2009 ◽  
Vol 46 (1) ◽  
pp. 81-84 ◽  
Author(s):  
Fernanda Prata Martins ◽  
Erika Pereira de Macedo ◽  
Gustavo Andrade de Paulo ◽  
Frank Shigueo Nakao ◽  
José Celso Ardengh ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Portal Hypertension ◽  
Gastric Varices ◽  
Study Endpoint ◽  
Mild Abdominal Pain ◽  
Threatening Condition ◽  
Life Threatening ◽  
Related Mortality ◽  
Overall Mortality

Bleeding from gastric varices is a life-threatening condition. We report our experience with cyanoacrylate injection. Twenty three patients with portal hypertension and gastric varices underwent intra-variceal injection of a cyanoacrylate/lipiodol solution (1:1). Study endpoint was variceal obliteration. Mean follow-up was 25.3 months. Variceal obliteration was achieved in 87% of patients. Recurrence occurred in one patient (4.3%) and rebleeding in another case (4.3%). Mild abdominal pain was described in 13% of patients. Overall mortality was 21.7% and rebleeding related mortality rate was 4.3%. Our results confirm that cyanoacrylate injection is effective and safe to eradicate gastric varices.

scholarly journals Abdominal pain: a survey of clinically important outcomes for future research

CJEM ◽  
2010 ◽  
Vol 12 (06) ◽  
pp. 485-490 ◽  
Author(s):  
Angela M. Mills ◽  
Anthony J. Dean ◽  
Judd E. Hollander ◽  
Esther H. Chen
Keyword(s):  
Abdominal Pain ◽  
Acute Abdominal Pain ◽  
Future Research ◽  
Original Research ◽  
Emergency Physicians ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Clinically Significant

ABSTRACT Objective: We aimed to use the consensus opinion of a group of expert emergency physicians to derive a set of emergency diagnoses for acute abdominal pain that might be used as clinically significant outcomes for future research. Methods: We conducted a cross-sectional survey of a convenience sample of emergency physicians with expertise in abdominal pain. These experts were authors of textbook chapters, peer-reviewed original research with a focus on abdominal pain or widely published clinical guidelines. Respondents were asked to categorize 50 possible diagnoses of acute abdominal pain into 1 of 3 categories: 1) unacceptable not to diagnose on the first emergency department (ED) visit; 2) although optimal to diagnose on first visit, failure to diagnose would not be expected to have serious adverse consequences provided the patient had follow-up within the next 2–7 days; 3) if not diagnosed during the first visit, unlikely to cause long-term risk to the patient provided the patient had follow-up within the next 1–2 months. Standard descriptive statistical analysis was used to summarize survey data. Results: Thirty emergency physicians completed the survey. Of 50 total diagnoses, 16 were categorized as “unacceptable not to diagnose in the ED” with greater than 85% agreement, and 12 were categorized as “acceptable not to diagnose in the ED” with greater than 85% agreement. Conclusion: Our study identifies a set of abdominal pain conditions considered by expert emergency physicians to be clinically important to diagnose during the initial ED visit. These diseases may be used as “clinically significant” outcomes for future research on abdominal pain.

scholarly journals Treatment of acute abdominal pain in the emergency room: A systematic review of the literature

2014 ◽  
Vol 18 (7) ◽  
pp. 902-913 ◽  
Author(s):  
C. Falch ◽  
D. Vicente ◽  
H. Häberle ◽  
A. Kirschniak ◽  
S. Müller ◽  
...  
Keyword(s):  
Systematic Review ◽  
Abdominal Pain ◽  
Emergency Room ◽  
Acute Abdominal Pain ◽  
Review Of The Literature

scholarly journals Somatosound: A review with report of 9 cases with long-term follow-up

2021 ◽  
Vol 26 (4) ◽  
pp. 631-642
Author(s):  
Byung In Han ◽  
Ho won Lee ◽  
Sanghyo Ryu ◽  
Beatrice Lucciani ◽  
Ji Man Hong ◽  
...  
Keyword(s):  
Symptomatic Treatment ◽  
Jugular Bulb ◽  
Temporomandibular Joint Disorders ◽  
Sound Therapy ◽  
Long Term Follow Up ◽  
Life Threatening ◽  
Long Term Observation ◽  
Ica Stenosis

Somatosound (somatic tinnitus) is associated with vascular, musculoskeletal, respiratory, or temporomandibular joint disorders. Several studies of its management have been widely reported, but only few presented long-term follow-up results. The purposes of this paper are to review the causes and management, present cases with long-term follow-up, together with previously reported cases in literatures. We treated nine patients with somatosound of vascular, hematologic, endocrinologic, muscular, and cervical origin. Follow-up were conducted routinely, and the final results were collated in 3 to 11 years. Patients with non-life-threatening causes were given counseling and palliative management. Their tinnitus becomes tolerable, gradually decreased, and even disappeared. Patients with life-threatening causes were treated immediately. Among all, there were three cases which to the best of our knowledge, are the first reported of its causes. One case was caused by a compensatory of increasing blood flow in internal carotid artery (ICA) secondary to contralateral ICA stenosis. Another had a combination of anemia and an ipsilateral jugular bulb diverticulum. The tinnitus disappeared after the anemia treated. The last was patient with hyperthyroidism. The tinnitus disappeared by controlling the condition. Even when the causes are benign and the available treatments may carry risks, the patients should not be left unmanaged. Symptomatic treatment should be given, such as counseling, sound therapy, and palliative management. Our long-term observation indicated that overall outcomes are positive when the etiologies are identified early and managed properly.

scholarly journals Spontaneous splenic rupture in dengue fever with non-fatal outcome in an adult

2012 ◽  
Vol 6 (04) ◽  
pp. 369-372 ◽  
Author(s):  
Emmanuel Bhaskar ◽  
Swathy Moorthy
Keyword(s):  
Abdominal Pain ◽  
Dengue Fever ◽  
Splenic Rupture ◽  
Fatal Outcome ◽  
Severe Dengue ◽  
Structural Protein ◽  
Viremic Phase ◽  
Laboratory Investigations ◽  
Splenic Hematoma

A 26-year-old male presented with fever for five days and abdominal pain for 24 hours. System examination identified a soft abdomen with diffuse tenderness. CT-abdomen findings were consistent with splenic rupture with intra and peri-splenic hematoma. Laboratory investigations showed a platelet count of 40,000 per mm3. In due course he developed hypotension and underwent splenectomy. Non-structural protein 1 (NS1) dengue antigen was positive in the admission sample and IgM dengue antibodies were detected in the follow-up sample. Histopathology of the spleen showed normal architecture with no evidence of hyperplasia, cellular infiltrates or haematological malignancy. Splenic rupture is a rare, but potentially fatal complication of dengue fever and severe dengue which should be suspected when a patient presents with abdominal pain and hypotension. Our case highlights the occurrence of splenic rupture in the viremic phase of dengue illness before the development of IgM antibodies. 

scholarly journals Evaluating Safety and Efficacy of Follow-up for Patients With Abdominal Pain Using Video Consultation (SAVED Study): Randomized Controlled Trial (Preprint)

2019 ◽  
Author(s):  
Dinesh Visva Gunasekeran ◽  
Zhenghong Liu ◽  
Win Jim Tan ◽  
Joshua Koh ◽  
Chiu Peng Cheong ◽  
...  
Keyword(s):  
Emergency Department ◽  
Randomized Controlled Trial ◽  
Abdominal Pain ◽  
Acute Abdominal Pain ◽  
Controlled Trial ◽  
Common Symptom ◽  
Safety And Efficacy ◽  
Randomized Controlled ◽  
Video Consultation

BACKGROUND The benefits of telemedicine include cost savings and decentralized care. Video consultation is one form that enables early detection of deteriorating patients and promotion of self-efficacy in patients who are well but anxious. Abdominal pain is a common symptom presented by patients in emergency departments. These patients could benefit from video consultation, as it enables remote follow-up of patients who do not require admission and facilitates early discharge of patients from overcrowded hospitals. OBJECTIVE The study aimed to evaluate the safety and efficacy of the use of digital telereview in patients presenting with undifferentiated acute abdominal pain. METHODS The SAVED study was a prospective randomized controlled trial in which follow-up using existing telephone-based telereview (control) was compared with digital telereview (intervention). Patients with undifferentiated acute abdominal pain discharged from the emergency department observation ward were studied based on intention-to-treat. The control arm received routine, provider-scheduled telereview with missed reviews actively coordinated and rescheduled by emergency department staff. The intervention arm received access to a platform for digital telereview (asynchronous and synchronous format) that enabled patient-led appointment rescheduling. Patients were followed-up for 2 weeks for outcomes of service utilization, efficacy (compliance with their disposition plan), and safety (re-presentation for the same condition). RESULTS A total of 70 patients participated, with patients randomly assigned to each arm (1:1 ratio). Patients were a mean age of 40.0 (SD 13.8; range 22-71) years, predominantly female (47/70, 67%), and predominantly of Chinese ethnicity (39/70, 56%). The telereview service was used by 32 patients in the control arm (32/35, 91%) and 18 patients in the intervention arm (18/35, 51%). Most patients in control (33/35, 94%; 95% CI 79.5%-99.0%) and intervention (34/35, 97%; 95% CI 83.4%-99.9%) arms were compliant with their final disposition. There was a low rate of re-presentation at 72 hours and 2 weeks for both control (72 hours: 2/35, 6%; 95% CI 1.0%-20.5%; 2 weeks: 2/35, 6%, 95% CI 1.0%-20.5%) and intervention (72 hours: 2/35, 6%; 95% CI 1.0%-20.5%; 2 weeks: 3/35, 9%, 95% CI 2.2%-24.2%) arms. There were no significant differences in safety (<i>P</i>&gt;.99) and efficacy (<i>P</i>&gt;.99) between the two groups. CONCLUSIONS The application of digital telereview for the follow-up of patients with abdominal pain may be safe and effective. Future studies are needed to evaluate its cost-effectiveness and usefulness for broader clinical application. CLINICALTRIAL ISRCTN Registry ISRCTN28468556; http://www.isrctn.com/ISRCTN28468556.

scholarly journals EVALUATION AND MANAGEMENT OF ACUTE ABDOMINAL PAIN

2020 ◽  
Vol 4 (12) ◽  
Author(s):  
Khaled Hassan
Keyword(s):  
Abdominal Pain ◽  
Acute Abdominal Pain ◽  
Evaluation Methods ◽  
Outpatient Setting ◽  
Quality Data ◽  
Patient History ◽  
Web Based ◽  
Pain Evaluation ◽  
Life Threatening ◽  
Good Quality Data

Background: Acute abdominal pain is a public problem in the outpatient setting and can represent conditions ranging from benign to life-threatening. The patient history, physical examination, laboratory testing, and diagnostic imaging are the major evaluation methods for acute abdominal pain. There was not sufficient good-quality data for the management of acute abdominal pain, where it relies on the knowledge and expertise of the doctors. A web-based search utilizing the advanced characteristics of different databases like PubMed, Google Scholar, Embase, Scopus, and Cochrane electronic databases was carried out. Here we aimed to review the major evaluation methods for acute abdominal pain and its management protocols. Keywords: Acute, Abdominal, Pain, Evaluation, Management, Review

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