Imaging and Laboratory Testing in Acute Abdominal Pain

Panebianco, Nova L.; Jahnes, Katherine; Mills, Angela M.

doi:10.1016/j.emc.2011.01.010

Cited by 25 publications

(25 citation statements)

References 53 publications

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“…<Comment> The guidelines of the American College of Emergency Physicians (ACEP) in 1994 recommended that clinicians must not rely solely on blood test data for the diagnosis of patients with abdominal pain (level 5). According to the results of emergency visit blood tests of 119,200,000 data of the American National Hospital Ambulatory Medical Care Survey (NHAMCS) reported in 2006, the frequently performed blood tests in patients with abdominal pain are complete blood counts (34.0%), BUN/creatinine (20.1%), electrolytes (19.1%), cardiac enzymes (19.0%), liver function tests (11.5%), and urinalysis (20.2%) (level 2).…”

Section: Resultsmentioning

confidence: 99%

Practice Guidelines for Primary Care of Acute Abdomen 2015

Mayumi

Yoshida

Tazuma

et al. 2015

J Hepato Biliary Pancreat

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Since acute abdomen requires accurate diagnosis and treatment within a particular time limit to prevent mortality, the Japanese Society for Abdominal Emergency Medicine, in collaboration with four other medical societies, launched the Practice Guidelines for Primary Care of Acute Abdomen that were the first English guidelines in the world for the management of acute abdomen. Here we provide the highlights of these guidelines (all clinical questions and recommendations were shown in supplementary information). A systematic and comprehensive evaluation of the evidence for epidemiology, diagnosis, differential diagnosis, and primary treatment for acute abdomen was performed to develop the Practice Guidelines for Primary Care of Acute Abdomen 2015. Because many types of pathophysiological events underlie acute abdomen, these guidelines cover the primary care of adult patients with nontraumatic acute abdomen. A total of 108 questions based on nine subject areas were used to compile 113 recommendations. The subject areas included definition, epidemiology, history taking, physical examination, laboratory test, imaging studies, differential diagnosis, initial treatment, and education. Japanese medical circumstances were considered for grading the recommendations to assure useful information. The two-step methods for the initial management of acute abdomen were proposed. Early use of transfusion and analgesia, particularly intravenous acetaminophen, were recommended. The Practice Guidelines for Primary Care of Acute Abdomen 2015 have been prepared as the first evidence-based guidelines for the management of acute abdomen. We hope that these guidelines contribute to clinical practice and improve the primary care and prognosis of patients with acute abdomen.

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Section: Resultsmentioning

confidence: 99%

Practice Guidelines for Primary Care of Acute Abdomen 2015

Mayumi

Yoshida

Tazuma

et al. 2015

J Hepato Biliary Pancreat

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“…Although acute appendicitis diagnosis is clinical, in some situations (diagnosis doubt) complementary tests might be useful. Only half of the patients present the classical clinical diagnosis of appendix infection 3,6,14 The retardation or misdiagnosis of this illness is harmful to the patient, which can present serious complications inherent to the evolution process of the appendix infection, which contributes to the increase of the morbimortality 6,13,15,17,19 . The objective of this study was to evaluate the main alterations of laboratory tests in patients with acute appendicitis, as well as its relation to the disease´s evolution, in order to provide a possible early diagnosis of this illness.…”

Section: Introdutionmentioning

confidence: 99%

Achados principais de exames laboratoriais no diagnóstico de apendicite aguda: uma avaliação prospectiva

Goulart¹,

Silvério²,

Moreira³

et al. 2012

ABCD, arq. bras. cir. dig.

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-Background -Acute appendicitis is the most common surgical abdominal disease in the emergency room. ABCDDV/848RESUMO -Racional -Apendicite aguda é a doença abdominal cirúrgica mais comum nas unidades de emergência. Embora o diagnóstico seja clínico, a realização de exames complementares pode ser útil na dúvida diagnóstica. Objetivo -Avaliar as principais alterações de exames laboratoriais em pacientes com apendicite aguda, assim como sua relação com a fase evolutiva da doença. Métodos -Avaliação prospectiva de pacientes com diagnóstico de apendicite aguda submetidos ao tratamento cirúrgico. Resultados -Cento e setenta e nove pacientes participaram deste estudo, a maioria do sexo masculino. A idade média foi de 26 anos. Em relação à contagem de leucócitos, 46,9% apresentavam valores <15.000 mm3. A porcentagem média dos polimorfonucleares foi de 81,7%, de bastões 1,2%, de eosinófilos 1%, de linfócitos 12,8% e de monócitos 2,9%. A proteína C reativa foi solicitada para 54 pacientes. Ela foi <10 mg/dl em 19, entre 10 e 50 mg/dl em 24 e maior ou igual a 50 mg/dl em 11. Com relação à fase evolutiva 64% pacientes apresentaram estágio inicial (fases 1 e 2), 16,2% fase 3 e 35 fase 4. 57% dos pacientes com contagem de leucócitos totais maior ou igual a 20.000/mm3 apresentaram perfuração apendicular (p<0,05). A porcentagem de leucócitos polimorfonucleados de pacientes com fases iniciais foi menor em relação às avançadas (79,8% e 85,1%, respectivamente), com valor de p<0,05. Pacientes com fases avançadas de apendicite aguda a quantidade de linfócitos foi menor em relação às iniciais (9,3% e 14,8%, respectivamente), com valor de p<0,05. Noventa e quatro porcento dos pacientes com valores de proteína C reativa <10 mg/dl apresentaram fases iniciais de inflamação apendicular (p<0,05). Conclusão -Houve associações significativas entre contagem total e diferencial de leucócitos, valores de proteína C reativa e fase evolutiva de inflamação apendicular.

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“…Lipase levels can be identifi ed in order to provide evidence of pancreatitis. Imaging studies include the hepatobiliary iminodiacetic acid (HIDA) scan, RUQ ultrasound, and/or CT-scan (46,47,50,51) . The magnetic resonance cholangiopancreatography (MRCP) is a type of MRI that is used to visualize the biliary and pancreatic ducts.…”

Section: Laboratory Studiesmentioning

confidence: 99%

Perspectives on acute abdominal pain in the college student: a clinically challenging conundrum

Greydanus

Rowlett

2012

International Journal on Disability and Human Development

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Acute abdominal pain in the college student can be due to many causes, some of which are considered in this discussion. The key to an accurate diagnosis is a meticulous medical history, careful physical examinations repeated over time, and judicious use of laboratory and/or imaging studies. The medical history may indicate red fl ags that alert the astute clinician to which causes are benign and which ones indicate serious pathology. Particularly important is the location of the pain and how it may change over time. The challenging features presented by acute abdominal pain in the college student include fi ndings, such as guarding or rigidity, signifying acute appendicitis or peritonitis vs. negative palpatory fi ndings that are non-specifi c with minimal clinical value. Appropriate follow-up over time is a valued tool in the clinician ' s armamentarium in the evaluation and management of acute abdominal pain.

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Imaging and Laboratory Testing in Acute Abdominal Pain

Cited by 25 publications

References 53 publications

Practice Guidelines for Primary Care of Acute Abdomen 2015

Practice Guidelines for Primary Care of Acute Abdomen 2015

Achados principais de exames laboratoriais no diagnóstico de apendicite aguda: uma avaliação prospectiva

Perspectives on acute abdominal pain in the college student: a clinically challenging conundrum

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