Study of etiological factors, clinical profile and outcomes of the non-traumatic acute abdomen in adult patients
DOI:
https://doi.org/10.18203/2349-2902.isj20250813Keywords:
Acute abdomen, Diagnosis, SurgeryAbstract
Background: Acute abdomen is the most prevalent surgical emergency. The natural history of acute abdomen is contingent upon the underlying disease process, which may, in some cases, resolve spontaneously with or without intervention, while in others, it may advance to widespread peritonitis and mortality. The need of this research is to conduct a clinical audit of patients with non-traumatic acute abdomen to facilitate early detection and prompt care. Objectives were to investigate the etiological causes, clinical characteristics, and outcomes of non-traumatic acute abdomen.
Methods: Descriptive research conducted in a tertiary teaching hospital over an 18-month period (November 2022 to April 2024). Patients with acute abdomen requiring over 24 hours of observation or inpatient treatment in the surgical wards were included. The diagnosis was established by clinical and investigative findings and then validated during laparotomy in the operated patients.
Results: The 123 eligible patients were picked up to participate in the study. Surgical management was done in 67.5% cases and 32.5% were managed conservatively. The 98.4% cases were discharged whereas mortality was documented in 1.6% cases.
Conclusions: The diversity in presentations and underlying causes emphasizes the crucial role of prompt and accurate diagnosis. Low mortality rate (1.6%) and relatively short hospital stay (average 6.8 days) suggest the effectiveness of this targeted approach. In conclusion, this study highlights the diverse presentations and underlying causes of non-traumatic acute abdomen. By considering the specific aetiology and tailoring treatment accordingly, healthcare professionals can ensure prompt and effective management of this complex condition.
Metrics
References
Kumar MS, Bharath B, Balasubramanya KS, Thinagaran K. The non traumatic acute abdomen and its clinical spectrum. Int Surg J. 2019;6:1710-5. DOI: https://doi.org/10.18203/2349-2902.isj20191895
Patterson JW, Kashyap S, Dominique E. Acute Abdomen. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2023.
Kamin RA, Nowicki TA, Courtney DS, Powers RD. Pearls and pitfalls in the emergency department evaluation of abdominal pain. Emergency Med Clin. 2003;21(1):61-72. DOI: https://doi.org/10.1016/S0733-8627(02)00080-9
Chanana L, Jegaraj MA, Kalyaniwala K, Yadav B, Abilash K. Clinical profile of non-traumatic acute abdominal pain presenting to an adult emergency department. J Family Med Pri Care. 2015;4(3):422. DOI: https://doi.org/10.4103/2249-4863.161344
Irvin TT. Abdominal pain: a surgical audit of 1190 emergency admissions. J Brit Surg. 1989;76(11):1121-5. DOI: https://doi.org/10.1002/bjs.1800761105
Sutha SK, Sellamoni S. Non Traumatic Abdominal Surgical Emergencies (Doctoral dissertation, Kilpauk Medical College, Chennai). RJPBCS. 2023;14(6):278.
Selbst SM, Friedman MJ, Singh SB. Epidemiology and etiology of malpractice lawsuits involving children in US emergency departments and urgent care centers. Pediatr Emerg Care. 2005;21(3):165-9.
Kachalia A, Gandhi TK, Puopolo AL, Yoon C, Thomas EJ, Griffey R, et al. Missed and delayed diagnoses in the emergency department: References Page 93 a study of closed malpractice claims from 4 liability insurers. Ann Emerg Med. 2007;49(2):196-205. DOI: https://doi.org/10.1016/j.annemergmed.2006.06.035
Elhardello OA, MacFie J. Digital rectal examination in patients with acute abdominal pain. Emerg Med J. 2018;35(9):579-80. DOI: https://doi.org/10.1136/emermed-2018-207631
Verki MM, Motamed H. Rectus muscle hematoma as a rare differential diagnosis of acute abdomen; a case report. Emergency. 2018;6(1):e28.
Kaushal-Deep SM, Anees A, Khan S, Khan MA, Lodhi M. Primary cecal pathologies presenting as acute abdomen and critical appraisal of their current management strategies in emergency settings with review of literature. Int J Crit Illness Injury Sci. 2018;8(2):90. DOI: https://doi.org/10.4103/IJCIIS.IJCIIS_69_17
Smith JE, Hall EJ. The use of plain abdominal x rays in the emergency department. Emerg Med J. 2009;26(3):160-3. DOI: https://doi.org/10.1136/emj.2008.059113
Gwynn LK. The diagnosis of acute appendicitis: clinical assessment versus computed tomography evaluation. J Emerg Med. 2001;21(2):119-23. DOI: https://doi.org/10.1016/S0736-4679(01)00353-5
Lee SL, Walsh AJ, Ho HS. Computed tomography and ultrasonography do not improve and may delay the diagnosis and treatment of acute appendicitis. Arch Surg. 2001;136(5):556-62. DOI: https://doi.org/10.1001/archsurg.136.5.556
Scoutt LM, Sawyers SR, Bokhari J, Hamper UM. Ultrasound evaluation of the acute abdomen. Ultrasound Clin. 2007;2(3):493-523. DOI: https://doi.org/10.1016/j.cult.2007.07.002
Macaluso CR, McNamara RM. Evaluation and management of acute abdominal pain in the emergency department. Int J General Med. 2012;5:789. DOI: https://doi.org/10.2147/IJGM.S25936
Abdullah M, Firmansyah MA. Diagnostic approach and management of acute abdominal pain. Acta Med Indones. 2012;44(4):344-50.
Prasad H, Rodrigues G, Shenoy R. Role of ultrasonography in non traumatic acute abdomen. Int J Radiol. 2006;5(2):1-2. DOI: https://doi.org/10.5580/676
Bux GM, Baaodhah AM, Mahrooqi SA. Non-traumatic Acute Abdomen: Clinical Presentation and Outcomes. Int Case Rep J. 2022;2(6):1-6.
Millham FH. Acute abdominal pain. In: Feldman M, Friedman LS, Brandt LJ, eds. Feldman: Sleisenger and Fordtran's gastrointestinal and liver disease. 9th ed. Philadelphia: Elvesier. 2010;151-62. DOI: https://doi.org/10.1016/B978-1-4160-6189-2.00010-X
Downloads
Published
How to Cite
Issue
Section
