Evaluation and management of acute abdominal pain in the emergency department

Abstract

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.

Age-Related Differences in Outcomes and Etiologies of Acute Abdominal Pain Based on a National Administrative Database

“…Acute abdominal pain is defined as severe pain arising in the abdominal area requiring immediate care (Macaluso and McNamara 2012). The wide variety in presentation of symptoms and the broad spectrum of associated diseases complicates the isolation of the cause of abdominal pain, which may vary from life-threatening diseases requiring emergency surgery to mild self-limiting causes (Laméris et al 2009).…”

Computerized tomography of the acute left upper quadrant pain

“…Acute abdominal pain is the most common chief complaint for which patients seek care in emergency departments in the United States [1]. History and physical examination may be helpful in limiting the differential diagnosis for the emergency physician, however a definite 7 diagnosis may remain elusive and thus imaging and laboratory testing are commonly ordered for further evaluation of the patient's pain [6].…”

“…Abdominal pain is the most common reason for a visit to the emergency department, comprising 7% of all complaints in the emergency departments (ED) and accounting for approximately 8 million ED visits annually [1]. Causes of abdominal pain vary widely, ranging from transient, non-life-threatening conditions such as gastroenteritis and urinary tract infections, to severe, lifethreating conditions such as abdominal aortic aneurysm rupture and bowel ischemia.…”

“…Causes of abdominal pain vary widely, ranging from transient, non-life-threatening conditions such as gastroenteritis and urinary tract infections, to severe, lifethreating conditions such as abdominal aortic aneurysm rupture and bowel ischemia. The location of the abdominal pain can often help to limit the differential diagnosis, however with left upper quadrant pain the potential causes vary widely, including cardiac, gastric, pancreatic, renal and vascular etiologies [1]. Current clinical practice guidelines offer mixed recommendations with regard to imaging patients with acute left upper quadrant pain, with some authors recommending CT of the abdomen [2] however there have been no formal studies in the radiology literature to support this practice.…”

Akut Abdomen

“…Ayırıcı tanıda kendini kısıtlayan patolojilerden hayatı tehdit edebilen durumlara kadar pek çok hastalık yer almakta olup klinik belirti ve bulguların müphem olduğu durumlarda spesifik medikal veya cerrahi tedavi gerektiren patolojilere tanı konması zorluk oluşturabilir [1]. Yanlış tanı, tedavinin gecikmesi yanında gereksiz cerrahilere de neden olabilir.…”