Negative laparotomy rates in acute abdomen: a declining trend

Abstract

INTRODUCTIONThe acute abdomen is one of the commonest causes of admission to the emergency surgical department. Acute abdomen is a condition of acute abdominal pain, vomiting and bowel complaints of less than 24 hour duration where it becomes mandatory for the treating physician to establish correct diagnosis and perform urgent surgery if the diagnosis is of operative cause. The correct interpretation of abdominal pain is one of the most challenging demand to any surgeon.1 It is of utmost importance to integrate the results of diagnostic investigations with the clinical findings in order to establish the diagnosis. 2-4 METHODSThe data collection was done from 105 cases of nontraumatic acute abdomen adult patients admitted to the emergency surgery department of the tertiary hospital and subsequently operated. The observations were tabulated and inferences drawn. Inclusion criteria Operated patients 13-80 age group acute abdomen cases  Operated non-traumatic acute abdomen cases. ABSTRACTBackground: A prospective observational study of 105 operated cases of non-traumatic acute abdomen in emergency setting in tertiary government hospital was carried out. The correlation between preoperative diagnostic, radiological and clinical assessment and operative findings was noted. The clinical and radiological diagnostic accuracy rates were calculated using descriptive statistical analysis. Negative laparotomy rates were calculated and compared to the previous studies. Methods: The most common finding was acute appendicitis and the most frequently involved age group was 21-40.The absence of correlation between preoperative diagnosis and operative findings was noted in 7 cases of which 2 cases of appendicitis had been missed on ultrasound and 2 cases of appendicular mass were reported as acute appendicitis where appendectomy could not be done on account of adhesions.2 cases of x-ray diagnosed obstruction with clinical features of vomiting ,constipation had no gross bowel pathology on laparotomy while one case diagnosed preoperatively as appendicitis turned out to be a case of renal colic with hydroureter. Results: The diagnostic accuracy rate of x-ray and ultrasound for obstruction/perforation and acute appendicitis were found to be 89.79% and 94.64% respectively. Conclusions: The negative laparotomy rates were low around 2.85%.

Evaluation of Preoperative Diagnostic Accuracy of Modified Alvarado Scoring System in Acute Appendicitis

“…15 Sabhnani G et al reported that majority of them with acute appendicitis were in the age group between 21 -40 yrs., which is in parallel to the current study findings where majority were in 21 -30 years' age group. 16 Kumar SK et al has also included the participants ranging between 7 -65 yrs. and males dominated the study which is similar to the current study findings.…”