Non-specific abdominal pain remains as the most common reason for acute abdomen: 26-year retrospective audit in one emergency unit

Fagerström, Anne; Paajanen, Paavo; Saarelainen, Heidi; Ahonen-Siirtola, Mirella; Ukkonen, Mika; Miettinen, Pekka; Paajanen, Hannu

doi:10.1080/00365521.2017.1342140

Cited by 61 publications

(50 citation statements)

References 16 publications

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“…AA is still the most common reason for AAP and the ratio of AA in patients with AAP is between 11-23% (17). The ratio of AA in this study was 32% (15 of 45 patients) which was higher than the literature.…”

Section: Discussioncontrasting

confidence: 74%

“…It was concluded that the RAMRI was significant and hopeful because the radiological analysis duration was shorter and it provided enough information. There are some disadvantages of the method; the patients who have claustrophobia and hearth battery are not allowed for MRI (17). Despite short analysis duration, diagnostic images may not be handled because of pain.…”

Section: Discussionmentioning

confidence: 99%

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Rapid Sequence MRI Analysis of Acute Abdominal Pain

Baykan¹,

Şahin²,

Inan³

et al. 2020

Eurasian J Emerg Med

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Aim: The aim of this study was to evaluate the diagnostic performance of non-contrast rapid sequences (RAMRI) visualization on cases who were clinically diagnosed as having acute abdominal pain (AAP). Materials and Methods: Forty-six patients were chosen from 2850 patients who were admitted to the emergency service between January 2016-January 2019 because of sudden onset abdominal pain and could not get a computerized tomography analysis. A 1.5 Tesla magnetic resonance (MR) device (GE Signa Hi-Speed, Milwaukee) was used for analysis. Coronal and axial T2-weighted single-shot fast spin-echo series were used as scan protocol. No intravenous, oral or rectal contrast material was used. The cases were identified as positive (+) or negative (-) by MRI. The cases who had symptoms related with AAP, were considered as positive (+), and the cases who did not have symptoms or had symptoms which were not related with AAP, were considered as negative (-). Results: Of the patients, 26 (56.5%), were female and 20 (43.5%) were male. The median age was 38.65 (18-86) years. The treatment methodology was surgery for 25 cases (54%) and conservative for 21 (46%) cases. The operative group (surgically treated) included 24 MR (+) and one MR (-) cases. There was a harmony between the clinic and MRI data of all members in non-surgical group. The accuracy of the study was calculated as 95.6% (44/46). The sensitivity of RAMRI was calculated as 96% for operative group and 100% for non-operative group. Conclusion: A successful diagnostic performance was achieved by non-contrast RAMRI in cases with AAP.

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Section: Discussioncontrasting

confidence: 74%

Section: Discussionmentioning

confidence: 99%

Rapid Sequence MRI Analysis of Acute Abdominal Pain

Baykan¹,

Şahin²,

Inan³

et al. 2020

Eurasian J Emerg Med

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“…For CT examinations of the head, these included acute intracranial hemorrhage and acute cerebral infarction; for CTA-HN, these included intracranial arterial thrombosis, occlusion or high-grade stenosis (> 70%) of the carotid or vertebral arteries, 21 and dural venous sinus thrombosis; for CTPA, these included pulmonary artery emboli; and for CT examinations of the abdomen and pelvis, these included acute appendicitis, diverticulitis, bowel obstructions, ureteric calculi and acute aortic syndrome. [22][23][24] Findings that were incidental and of doubtful clinical significance were not considered as new findings (e.g., brain atrophy and microan gio pathic ischemic change typical for age on CT examinations of the head, mild carotid stenosis [< 30%] on CTA-HN, dependent subsegmental atelectasis and incidental pulmonary nodules < 6 mm on CTPA, and cholelithiasis, diverticulosis and small fat-containing hernias on CT examinations of the abdomen and pelvis).…”

Section: Data Collection and Extractionmentioning

confidence: 99%

Effect of COVID-19 on computed tomography usage and critical test results in the emergency department: an observational study

Agarwal

Udare

Patlas

et al. 2020

cmajo

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(COVID-19) has had a major impact on the delivery of health care worldwide. 1 To prepare for a potential surge of patients with COVID-19 and to reduce the risk of COVID-19 transmission, many medical societies recommended that nonurgent medical procedures such as colonoscopy, Papanicolaou smears and mammography for cancer screening be delayed or rescheduled. 2-4 Preliminary data suggest that the volume of nonurgent procedures markedly decreased during the initial phase of the COVID-19 pandemic in North America. 5,6 Many governments issued policies for the provision of care; for example, the Ontario provincial government issued Directive 2 on Mar. 19, 2020, stating that all nonessential and elective health care services be stopped or reduced to minimal levels. 7 In addition to the COVID-19 pandemic's effects on the delivery of elective and nonurgent health care, there is evidence of a reduction in delivery of care for diseases requiring urgent management. Garcia and colleagues found a 38% reduction in cardiac catheterizations for ST-elevation myocardial infarction at the beginning of the pandemic in the United States. 8 They hypothesized that this may have been Effect of COVID-19 on computed tomography usage and critical test results in the emergency department: an observational study

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“…The leading gastrointestinal reason for an emergency visit in 2012 was a functional or motility disorder, diagnosed in 11.2% of all gastrointestinal patients [13]. A recent long-term study (1980–2012) of emergency room visits in Finland showed non-specific abdominal pain was the most common diagnosis [14]. A recent survey study of 1924 patients with a history of gastrointestinal symptoms showed 43% were not formally diagnosed with IBS despite meeting the diagnostic criteria for this condition [15].…”

Section: Epidemiology Of Chronic Pancreatitismentioning

confidence: 99%

Total pancreatectomy for recurrent acute and chronic pancreatitis: a critical review of patient selection criteria

Faghih

González

Makary³

et al. 2017

Current Opinion in Gastroenterology

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Purpose of review Critical review of the indications for total pancreatectomy and highlight limitations in current diagnostic criteria for chronic pancreatitis. Recent findings The diagnosis of noncalcific chronic pancreatitis remains controversial because of an overreliance on nonspecific imaging and laboratories findings. Endoscopic ultrasound, s-magnetic resonance cholangiopancreatography, and/or endoscopic pancreatic function testing are often used to diagnose noncalcific chronic pancreatitis despite the fact that there is no gold standard for this condition. Abdominal pain is not specific for chronic pancreatitis and is more likely to be encountered in patients with functional gastrointestinal disorders based on the high incidence of these conditions. The duration of pain and opioid analgesic use results in central sensitization that adversely affects pain outcomes after total pancreatectomy. An alcoholic cause is associated with poorer pain outcomes after total pancreatectomy. Summary The lack of a gold standard for noncalcific chronic pancreatitis limits the diagnostic accuracy of imaging and laboratory tests. The pain of chronic pancreatitis is nonspecific and is affected by duration, preoperative opioid use, and cause. These factors will need to be considered in the development of future selection criteria for this morbid surgery.

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Non-specific abdominal pain remains as the most common reason for acute abdomen: 26-year retrospective audit in one emergency unit

Abstract: NSAP is still the main differential diagnostic problem in the ED. Except acute appendicitis, distribution of specific diagnoses causing AAP remained rather stable through 26-year audit.

Cited by 61 publications

References 16 publications

Rapid Sequence MRI Analysis of Acute Abdominal Pain

Rapid Sequence MRI Analysis of Acute Abdominal Pain

Effect of COVID-19 on computed tomography usage and critical test results in the emergency department: an observational study

Total pancreatectomy for recurrent acute and chronic pancreatitis: a critical review of patient selection criteria

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