Analysis of Differential factors for Detecting Surgical Acute Abdomen in Women of Childbearing Age Presenting to the Emergency Department with Non-traumatic Abdominal Pain in the Absence of Laboratory Abnormalities.
- Author:
Hyung Jun SONG
1
;
Jun Hee LEE
Author Information
1. Department of Emergency Medicine, Sanbon Hospital, Wonkwang University College of Medicine, Gunpo, Korea. Inhaed@gmail.com
- Publication Type:Original Article
- Keywords:
Acute abdomen;
Women;
Abdominal pain;
Hospital emergency services;
Laboratories
- MeSH:
Abdomen, Acute*;
Abdominal Pain*;
Diagnosis;
Diagnosis, Differential;
Diarrhea;
Emergencies*;
Emergency Service, Hospital*;
Female;
Hand;
Humans;
Physical Examination;
Pregnancy;
Radiation Exposure;
Retrospective Studies
- From:Journal of the Korean Society of Emergency Medicine
2017;28(6):665-675
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Acute abdomen in women of childbearing age has a broad differential diagnosis, often presenting a diagnostic challenge to an emergency physician. Computed tomography (CT) has been used for an accurate diagnosis and prompt treatment of acute abdomen. On the other hand, the increasing use of CT has been a subject of concern for patients, particularly women of childbearing age, due to the potential risk of radiation exposure. This study analyzed the efficacy of various physical examinations for detecting surgical acute abdomen in women of childbearing age who presented with non-traumatic abdominal pain in the absence of laboratory abnormalities. METHODS: The charts and CT reports of women, aged 15-35 years old, who visited our ED for non-traumatic abdominal pain between May 2011 and April 2017 were reviewed retrospectively. Patients with chronic abdominal disease, pregnancy, recent abdominal surgery within one month, and abnormal laboratory tests were excluded. RESULTS: In total, 121 patients were identified, of which 34 patients fell into a group that required surgical intervention (surgical acute abdomen group). The remaining 87 patients were managed conservatively without surgical intervention (non-surgical acute abdomen group). The maximal tenderness point (p=0.006), rebound tenderness (p=0.001), shorter duration of abdominal pain (p < 0.001), and absence of diarrhea (p=0.001) were statistically significant for predicting the need for surgical intervention. CONCLUSION: In the absence of abnormal laboratory studies, the hypogastrium tenderness point, rebound tenderness, duration of abdominal pain, and diarrhea were found to be independently valid factors for detecting surgical acute abdomen in women of childbearing age who presented with non-traumatic abdominal pain.
