Publication:

Results of emergency management of acute abdomen in adults based on clinical assessment and basic imaging investigations: are advanced imaging techniques always necessary for successful treatment?

Background The term acute abdomen refers to signs and symptoms of abdominal pain and tenderness, a clinical presentation that may require emergency surgical treatment. Patients suffering from both, surgical as well as medical diseases may present with acute abdomen. The main objectives of the study are to identify common causes of acute abdomen, to assess the need for urgent surgical intervention in these patients and to evaluate role of basic diagnostic techniques and need of advanced imaging studies.

Methods Forty patients with acute onset abdominal pain were included in the study. Patients with pain related to pregnancy, trauma and pediatric age group were excluded from the study. All patients were subjected to detailed history and clinical examination, X-ray abdomen in erect position and ultrasound examination of the abdomen and pelvis. CECT of abdomen and pelvis was performed only when there were diagnostic difficulties and for deciding about need for surgical intervention.

Results Out of 40, fifteen (37.5%) patients required surgery within 24 hours and 14 (35%) patients underwent elective surgery after emergency treatment. Eleven (27.5%) patients were managed conservatively.

Conclusion Study shows that the commonest causes for acute abdomen are acute appendicitis and cholelithiasis with /without cholecystitis. Almost 1/3rd of the patients required emergency surgery. And CECT of abdomen and pelvis was helpful in decision making between conservative and surgical management of acute abdomen in selected cases.