Acute abdomen presentation in dengue haemorrhagic fever in South Indian population: An observational study

Abstract

To ascertain different etiologies for abdominal pain in dengue fever with their respective incidence and their management. Patients and Methods: Patients admitted with dengue fever (Confirmed by ELISA or NS1Ag) with pain abdomen in our hospital were included in the study. The cause of pain abdomen ascertained clinically and by following test: Pancreatitis -amylase, lipase, USG, CECT, Hepatitis -liver function test, Hollow viscous perforation Erect -X-ray abdomen, Cholecystitis -USG, Appendicitis -TLC, USG. Results: Out of total cases (n=214) included into the study features of acalculous cholecystitis were seen in 122 (58%) patients, pancreatitis in 24 (11.5%), appendicitis in 4 (1.9%), hepatitis: 27 (12.9%) non-specific in 33 (15.7%) patients. All of the patients were managed conservatively and regularly followed up till they became asymptomatic. None of the patients required any surgical intervention. All the patients responded well to conservative line of management and were discharged. Conclusions: Abdominal pain developing in dengue patients mimics many of surgical emergencies like cholecystitis, appendicitis, hepatitis, pancreatitis. Most of these patients respond well to conservative line of management with I.V fluids, antibiotics, analgesics without the need for any surgical intervention. Hastily taken decisions with operative management for such patients have led to serious consequences in the past. Our study supports conservative line of management in such scenarios and advocates avoidance of surgical option. Our study also throws light on the various modes of presentations, with their respective percentages.

Predictive markers for the early prognosis of dengue severity: A systematic review and meta-analysis

“…Regarding vomiting, Vuong et al, 2016 suggested two episodes per day to predict severe dengue in general [80]; another study proposed three times per day associated with plasma leak [100]. Next, PLOS NEGLECTED TROPICAL DISEASES many causes explain the acute abdominal pain in dengue, from non-specific to the more specific causes such as hepatitis, acalculous cholecystitis, pancreatitis, or several unusual causes [101][102][103][104], still having been merely referred to as "abdominal pain". It is clear that individuals who have a greater number of vomiting episodes are more likely to experience complicated dengue, and different clinical manifestations could speak to the different progressions.…”