Long-term Outcome of Patients with Acute Non-Specific Abdominal Pain Compared to Acute Appendicitis: Prospective Symptom Audit after Two Decades

Fagerström, Anne; Miettinen, Pekka; Valtola, Jaakko; Juvonen, Petri; Tarvainen, Riitta; Ilves, Imre; Paajanen, Hannu

doi:10.1080/00015458.2014.11680976

Cited by 10 publications

(4 citation statements)

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“…Similar results have been reported in adult patients suffering from NSAP 2. Over 70% of patients were free of symptoms after 20 years of follow-up, but their mortality was higher and various alimentary track diseases were more frequently observed than in controls.…”

Section: Commentarysupporting

confidence: 87%

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Childhood non-specific abdominal pain may predict adulthood organic and functional abdominal disease in a small number of patients

Paajanen

2016

Evid Based Med

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Section: Commentarysupporting

confidence: 87%

“…About 40–50% of adults abdominal pain is thought to be of functional origin, and in children this increases to 80–90% 2 5. Only 1.6% of children with a diagnosis of NSAP were later found to have an identifiable organic cause.…”

Section: Commentarymentioning

confidence: 99%

Childhood non-specific abdominal pain may predict adulthood organic and functional abdominal disease in a small number of patients

Paajanen

2016

Evid Based Med

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“…In previous follow-up studies, no single explanatory reason for NSAP has been found [3,29]. During long-term follow-up, the most common findings in the patients with NSAP were lactose intolerance, depression, musculoskeletal pain, and biliary disease during over 20 years of follow-up [30]. In addition to endoscopy examinations, our experience supports to refer selected NSAP patient once to abdominal MRI to rule out organ-specific diseases.…”

Section: Discussionmentioning

confidence: 53%

Diagnostic Potential of Magnetic Resonance Imaging in Chronic Abdominal Pain

et al. 2019

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Introduction: About half of the adult patients suffering from chronic abdominal pain may have no organ-related cause. Our purpose was to evaluate the additional information of magnetic resonance imaging (MRI) in diagnosing the underlying organic causes of such pain. Methods: We performed retrospective audit of 636 consecutive abdominal MRI in patients suffering from nonspecific abdominal pain (NSAP) during years 2014-2017. Medical history, clinical examination, endoscopy reports, and the results of MRI were compared in all patients. The hypothesis was that MRI increases markedly the diagnostic specificity of patients' symptoms. Results: The mean age of patients was 66 ± 14 years and 60 percent were females. Duration of abdominal pain ranged from 1 month to 30 years (median 1.1 ± 4.0 years). Concurrently with abdominal MRI (n = 636), also ultrasound (n = 106, 17%), colonoscopy (n = 222, 35%), and gastroscopy (n = 217, 34%) were performed. Abdominal MRI revealed additional information in 161/636 (25%) of NSAP patients. Spinal and pelvic bone abnormalities (n = 107) and malignant tumors (n = 31) were the most significant organ-specific findings changing the treatment algorithm. Conclusions: When computerized tomography is not available in outpatient clinics, abdominal MRI increases markedly diagnostic specificity and alters the treatment in 1 of 4 patients suffering from NSAP. Abdominal MRI is therefore suggested for patients suffering from severe symptoms of NSAP.

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“…Dans notre étude, les DANS n'étaient pas significativement associés à une chronicisation des douleurs. Une étude belge a montré que vingt ans après un diagnostic initial de DANS ou d'appendicite, la proportion de patients présentant des douleurs récurrentes était significativement plus élevée dans le groupe des DANS (29 % vs 11 % p <0,0001) [28]. L'absence de majoration du risque de chronicisation en cas de DANS dans notre étude s'explique peut-être par le fait que nous n'avons pas pris en compte d'éventuels changements de diagnostic survenus au cours de la période de suivi.…”

Section: Discussionunclassified

Chronicization of non-traumatic acute abdominal pain in emergency department: Incidence and predictive factors

Durand

Bounes

Lauque

2015

Ann. Fr. Med. Urgence

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Objectif : L'objectif de notre étude était de détermi-ner l'incidence de la chronicisation des douleurs chez les patients ayant consulté aux urgences pour une douleur abdominale aiguë non traumatique. Patients et méthode : Nous avons réalisé une étude rétrospec-tive au sein des urgences d'un hôpital universitaire entre juin 2013 et juin 2014. Les patients ont été sélectionnés via la banque informatisée des données des urgences, puis contactés pour un entretien téléphonique trois mois après leur passage aux urgences. Le critère de jugement principal était la persistance d'un score douloureux par échelle numérique (EN) supérieur à 3, à une fréquence minimale de deux fois par mois, trois mois après le passage aux urgences. Résultats : Sur les 440 patients éligibles, 200 patients ont pu être contactés et ont donné leur consentement. Quarante-deux patients (21 %) décrivaient la persistance d'une douleur avec une EN supérieure à 3/10 au moins deux fois par mois. Les facteurs associés à un risque de chronicisation étaient : l'âge (ratio de côtes (RC) 1,02 IC95 % [1,01-1,05] par année) et le score de la classification clinique des malades aux urgences (RC 0,40 IC95 % [0,21-0,75] par unité). Cent vingt-deux patients (61 %) n'ont pas présenté de récidive douloureuse dans les trois mois suivant leur admission aux urgences. Conclusion : La chronicisation des douleurs après une consultation aux urgences pour des douleurs abdominales aiguës concerne un patient sur cinq. L'âge et la gravité initiale de l'état clinique sont des facteurs prédictifs de chronicisation. L'absence de diagnostic organique (41 %) n'était pas associée, dans notre étude, à un risque de chronicisation. Mots clés Douleur abdominale · Chronicisation · OligoanalgésieAbstract Objective: The aim of this study was to investigate incidence of chronicization of pain in patients suffering from acute non-traumatic abdominal pain and discharged from emergency department (ED). Methods: We conducted a retrospective study in an academic hospital ED between June 2013 and June 2014. Patients were selected on ED electronic database, and then contacted for a phone interview three months after discharge. The main outcome was a pain score up to 3/10 on a numerous scale, more than twice a month, three months after discharge from ED. Results: Among the 440 patients completing inclusion criteria, 200 patients were contacted and gave their consent. Forty-two patients (21%) reported abdominal pain with an intensity more than 3/10 and with a frequency more than twice a month. Factors associated with pain chronicization where age (odds-ratio (OR) 1,02 IC95% [1,01-1,05] pear year and clinical gravity score at admission (OR 0,40 IC95% [0,21-0,75] pear level). One hundred and twenty two patients (61%) reported no pain during the three months of follow-up. Conclusions: One patient out of five is exposed to chronicization of his abdominal pain three months after discharge from ED. Age and clinical gravity score at admission are risk factors for pain chronicization. The lack of organic d...

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Long-term Outcome of Patients with Acute Non-Specific Abdominal Pain Compared to Acute Appendicitis: Prospective Symptom Audit after Two Decades

Cited by 10 publications

References 0 publications

Childhood non-specific abdominal pain may predict adulthood organic and functional abdominal disease in a small number of patients

Childhood non-specific abdominal pain may predict adulthood organic and functional abdominal disease in a small number of patients

Diagnostic Potential of Magnetic Resonance Imaging in Chronic Abdominal Pain

Chronicization of non-traumatic acute abdominal pain in emergency department: Incidence and predictive factors

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