Pearls and pitfalls in the emergency department evaluation of abdominal pain

Kamin, Richard; Nowicki, Thomas; Courtney, David S; Powers, Robert D.

doi:10.1016/s0733-8627(02)00080-9

Cited by 159 publications

(114 citation statements)

References 35 publications

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“…Oophorectomy can be performed in older patients. It should be taken into consideration, that young patients with ovarian germ cell tumors may be associated with acute abdomen [41] .Hemodynamic parameters in patients with ovarian cyst rupture may be impaired due to blood loss [1,42] .Suturing, cauterization of the bleeding site or cyst excision can be performed for ovarian cyst rupture [42] .Hemodynamic parameters in these patients were stable and there was no need for blood transfusion.…”

Section: Gynaecological Causesmentioning

confidence: 99%

“…Acute abdominal pain is one of the most common presenting complaints at emergency of general surgery department and due to its varied aetiology it poses significant diagnostic challenges for surgeons [1] Acute abdomen is a term used to encompass a spectrum of surgical, medical and gynaecological conditions ranging from trivial to life threatening conditions, which require hospital admission, investigations and treatment.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

"A Clinical Study of Non Traumatic Acute Abdomen in Female Patients”

Rao¹

2017

IOSR JDMS

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Section: Gynaecological Causesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

"A Clinical Study of Non Traumatic Acute Abdomen in Female Patients”

Rao¹

2017

IOSR JDMS

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“…Acute abdominal pain is one of the most common presenting complaints at emergency of general surgery department and due to its varied aetiology it poses significant diagnostic challenges for emergency surgeons [1]. At presentation, it is usually of sudden onset and associated with features like nausea, anorexia, vomiting, tachycardia etc.…”

Section: Introductionmentioning

confidence: 99%

Spectrum of Diseases in Patients with Non-Traumatic Acute Abdominal Pain Presenting to General Surgery Department in a Rural Tertiary Care Centre in West Bengal

2016

IJSR

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Background: Acute non-traumatic abdominal pain is one of the most common presenting symptoms in emergency of a general surgery department. The aetiology is varied for a common symptom and so it is very important to come to an early diagnosis for proper management. Objective: To identify the spectrum of diseases leading to acute onset non-traumatic abdominal pain, presented in the general surgery department. Design: Institution based prospective observational study. Setting: Department of General Surgery, B.S. Medical College, Bankura. Duration: January 2015 to December 2015. Materials and methods: All patients more than 12 years of age presented with non-traumatic abdominal pain in the general surgery department from January 2015 to December 2015 were included in this study. The demographics, diagnosis and outcome were noted in a predesigned, pretested proforma and analyzed. Results: The study cohort included total 3538 patients out of which 54.35% were male. Majority (54.74%) of the patients were in 25-50 years of age group consisting of 26.59% male and 28.15% female. Patients who came for treatment were mostly from lower class of socio-economic group (59.97%) according to SEC by Government of India. 56.21% patients presented with pain for >72 hours duration. The most common site affected being lower abdomen (46.72%), followed by upper abdomen (36-43%) and periumbilical (12.37%). 4.46% patients presented with generalized abdominal pain. Pain was sudden in onset in 67.21% patients (2378/3538) and 54.97% patients were having 5-7 scale pain at presentation according to Numeric rating scale of pain. Most common cause was found to be acute appendicitis (16.3%) followed by acute pancreatitis (11.92%), acute cholecystitis (9.60%) and renal colic (7.49 %). 74.61% (2640/3538) patients were managed conservatively and surgical intervention was needed in 25.38% patients. In hospital mortality rate was 1.72%. Conclusion: The most common cause of non traumatic acute abdominal pain in this study was acute appendicitis affecting young and middle aged population, followed by acute pancreatitis and acute cholecystitis.

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“…Early diagnosis and prompt surgical intervention in the form of laparotomy/laproscopy is required in these patients to reduce post-operative mortality and morbidity. 1 Post-operative hyperbilirubinemia is most commonly seen in patients undergoing emergency surgery. The incidence of abnormal post-operative liver functions tests range from 25% to 75%.…”

Section: Introductionmentioning

confidence: 99%

Self Limiting Postoperative Hyperbilirubinemia in Acute Abdomina L Conditions : A Study at Rims, Kadapa, Andhra Pradesh

Giridhar¹,

Sukumar²,

Pavani³

et al. 2015

jemds

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Self-limiting postoperative hyperbilirubinemia is seen in most of patients who undergo surgery for acute abdominal conditions like acute appendicitis, peritonitis, blunt injury abdomen, penetrating injury abdomen, intestinal obstruction etc. MATERIALS AND METHODS: Prospective study of 200 cases who were operated for acute abdominal conditions from June 2012 to June 2015 were included in the study. RESULTS: Out of 200 patients included in the study around 158 patients had postoperative hyperbilirubinemia which is around 79% of total patients which is significant. CONCLUSION: Postoperative hyperbilirubinemia is seen in most of cases of acute abdomen and these is found to be clue to circulating endotoxins which may impair the excretion of bilirubin by bile canaliculi and also bacterial load overwhelms kupffer cells function and may cause hepatocyte dysfunction. This hyperbilirubinemia is self-limiting and no specific management is necessary. By 5 th to 7 th postoperative day serum bilirubin levels are coming to normal level.

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Pearls and pitfalls in the emergency department evaluation of abdominal pain

Cited by 159 publications

References 35 publications

"A Clinical Study of Non Traumatic Acute Abdomen in Female Patients”

"A Clinical Study of Non Traumatic Acute Abdomen in Female Patients”

Spectrum of Diseases in Patients with Non-Traumatic Acute Abdominal Pain Presenting to General Surgery Department in a Rural Tertiary Care Centre in West Bengal

Self Limiting Postoperative Hyperbilirubinemia in Acute Abdomina L Conditions : A Study at Rims, Kadapa, Andhra Pradesh

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