DOI: http://dx.doi.org/10.18203/2349-2902.isj20202818

A study on the incidence of abdominal malignancies presenting as acute abdomen in an emergency department

Pauly T. Joseph, Lisha N. P., Roshjo Roshan, Saheer Neduvanchery

Abstract


Background: Acute abdomen is one of the most common symptoms that bring a patient to an emergency department. An abdominal malignancy may be the cause of acute abdomen at least in a number of cases. The problem with this is the poorer outcome associated with it due to the lack of preoperative evaluation and preparation and also possible contamination that occurs in case of a perforation. This study aimed at studying the incidence of abdominal malignancies in the patients presenting as acute abdomen and the various presentations in which they present.

Methods: Patients who presented with non-traumatic acute abdominal pain in the emergency department at our hospital who required surgery for acute abdomen were taken for the study and the incidence of malignancy in these cases were statistically assessed.

Results: Out of the 375 patients who were operated for non-traumatic acute abdomen 62 patients i.e. 16.53% were found to have intraabdominal malignancy. Carcinoma colon was the commonest malignancy, 51.6%. Carcinoma stomach and rectum were the next most common malignancy. Commonest presentation was as a case of intestinal obstruction, 72.6% followed by perforation, 20.9%.

Conclusions: In the era were the incidence and early detection of abdominal malignancies are on a rise, a significant portion of these cases present with acute abdominal symptoms and the morbidity associated with such a presentation is of importance. Early detection of the disease by screening is the solution for this.


Keywords


Acute abdomen, Emergency laparotomy, Malignancy

Full Text:

PDF

References


Chanana L, Jegaraj MAK, Kalyaniwala K, Yadav B, Abilash K. Clinical profile of non-traumatic acute abdominal pain presenting to an adult emergency department. J Fam Med Primary Care. 2015;4(3):422-5.

Trentzsch H, Werner J, Jauch KW. Acute abdominal pain in the emergency department- a clinical algorithm for adult patients. Zentralbl Chir. 2011;136:118-28.

Macaluso CR, McNamara RM. Evaluation and management of acute abdominal pain in the emergency department. Int J Gen Med. 2012;5:789-97.

Murchie P, Smith SM, Yule MS, Adam R, Turner ME, Lee AJ, et al. Does emergency presentation of cancer represent poor performance in primary care? Insights from a novel analysis of linked primary and secondary care data. Br J Cancer. 2017;116(9):1148-58.

Waldron RP, Donovan IA, Drumm J, Mottram SN, Tedman S. Emergency presentation and mortality from colorectal cancer in the elderly. Br J Surg, 1986;73:214-6.

Greenlee HB, Pienkos EJ, Vanderbilt PC, Byrne MP, Mason JH, Banich FE, et al. Acute large bowel obstruction: Comparison of county, veterans administration, and community hospital populations. Arch Surg. 1974;108(4):470-6.

Roviello F, Rossi S, Marrelli D, Manzoni GD, Pedrazzani C, Morgagni P, et al. Perforated gastric carcinoma: a report of 10 cases and review of literature. World J Surg Oncol. 2006:4;19.

Vijayakumar KK, Arun D, Deshpande MM, Moolchandani S. Epidemiological and clinical patterns of presentation of surgical oncological emergencies of abdomen at a tertiary institution. Int Surg J. 2017;4:890-2.