Original Research Article
Year: 2017 | Month: May | Volume: 7 | Issue: 5 | Pages: 17-22
Pattern and Presentation of Non-Traumatic Acute Abdominal Pain to an Emergency Department of a Tertiary Care Hospital
Dr. Ritesh Gajjar1, Dr. P.B.Gupta2, Dr. Diwakar Verma1, Dr. Binod Gouda1
1Resident Doctor, Department of Emergency Medicine, Government Medical College, Surat
2Professor and Head, Department of Emergency Medicine, Government Medical College, Surat
Corresponding Author: Dr. Ritesh Gajjar
ABSTRACT
Abdominal pain is one of the most common emergency presenting to emergency department(ED). It poses a diagnostic challenge for the emergency physicians as the causes are numerous, ranging from benign to life threatening conditions. Emergency physician must consider multiple diagnoses, especially those life-threatening conditions that require timely intervention to limit morbidity and mortality. This prospective observational study was conducted in a large ED of a tertiary care center in India. All patients older than 15 years and presenting with non-traumatic abdominal pain to the ED from July 2016 to December 2016 were included in study and their clinical profile, diagnosis were analysed. A total of 204 patients were included in the study. Almost half (52%) of the patients were in the age group of 15-30 years. 63% patients were male showing male predominance in our study. The onset of pain was sudden in 64% of patients. WBF scale was used to grade the severity of pain. WBF scale score of 1-4, 5–7 and 8–10 was seen in 50%, 36%and 14% of patients, respectively. Common types of pain included dull aching (49%) and colicky (34%). 39% patients reported lower abdominal pain, while 21% had upper abdominal location. The pain was generalized in 40% of patients. The majority of patients (80%) did not have any radiation of the pain. The groin, back and shoulder were the common sites of radiating pain in 11%, 07% and 02%, respectively. Common associated symptoms included nausea (56%), vomiting (42%), urinary symptoms (18%), and loss of appetite (13%).Out of total 204 patients 46% were admitted for further workup and management while 52% were discharged from emergency department while 02% of patients took discharge at request. The final diagnosis at discharge was grouped as follows: Surgical (32%), gastrointestinal (24%), urinary tract related (29%), obstetrics and gynaecology related (3%) and nonspecific diagnosis (12%). The most common reasons for ED visits due to abdominal pain were ureteric colic (22%), acute gastroenteritis (11%), acid peptic disease (11%), UTI (7%), hollow viscus perforation (08%) and acute appendicitis (07%).
Key words: Acute abdominal pain, non-traumatic causes of abdominal pain, emergency department