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Terapevticheskii Arkhiv Mar 2023Abdominal pain is a symptom that determines the accuracy and timeliness of diagnosis, treatment, and prognosis. The article describes the causes of acute and chronic...
Abdominal pain is a symptom that determines the accuracy and timeliness of diagnosis, treatment, and prognosis. The article describes the causes of acute and chronic abdominal pain, particularly the pain in the abdominal wall, and the challenges in recognizing them. The pathogenetic features of visceral, parietal, referred, and psychogenic pain and the principles of symptomatic therapy are addressed. It is emphasized that complex invasive examinations of the abdominal organs are especially relevant for elderly patients who often have conditions that require computed tomography, including contrast-enhanced scans. Without losing the importance of modern examination methods used in clinical practice, the author states that a detailed medical history and a thorough physical examination can significantly narrow the work-up. Endoscopic and other instrumental invasive examinations should be strictly justified and applied with a cost-effective rational approach.
Topics: Humans; Aged; Abdominal Pain; Prognosis
PubMed: 37167126
DOI: 10.26442/00403660.2023.02.202055 -
Nederlands Tijdschrift Voor Geneeskunde Apr 2023Abdominal pain can be part of a variety of abdominal and non-abdominal conditions. Individual symptoms and signs from history taking and physical examination have...
Abdominal pain can be part of a variety of abdominal and non-abdominal conditions. Individual symptoms and signs from history taking and physical examination have limited discriminatory value for a clear diagnosis. Additional laboratory testing strategies and imaging techniques can provide more guidance in this respect. In this article, we will answer specific practical questions with respect to abdominal pain. Topics discussed include various abdominal conditions, diagnostic markers, the diagnostic value of imaging techniques and the most recent changes in the policies for the diagnosis of appendicitis, cholecystitis and diverticulitis.
Topics: Humans; Abdominal Pain; Gastrointestinal Diseases; Appendicitis; Abdomen; Cholecystitis; Diagnosis, Differential
PubMed: 37078557
DOI: No ID Found -
Nederlands Tijdschrift Voor Geneeskunde May 2019Abdominal pain Abdominal pain can be part of a variety of abdominal and non-abdominal conditions. Individual symptoms and signs from history taking and physical...
Abdominal pain Abdominal pain can be part of a variety of abdominal and non-abdominal conditions. Individual symptoms and signs from history taking and physical examination have limited discriminatory value for a clear diagnosis. Additional laboratory testing strategies and imaging techniques can provide more guidance in this respect. In this article, we will answer specific practical questions with respect to abdominal pain. Topics discussed include various abdominal conditions, diagnostic markers, the diagnostic value of imaging techniques and new treatments for irritable bowel syndrome.
Topics: Abdominal Pain; Chronic Disease; Diagnosis, Differential; Gastrointestinal Diseases; Humans; Irritable Bowel Syndrome; Physical Examination; Radiography, Abdominal
PubMed: 31120214
DOI: No ID Found -
Emergency Medicine Clinics of North... May 2016Emergency department providers have become skilled at triaging patients with abdominal pain requiring surgical interventions. Abdominal pain mimics, medical conditions... (Review)
Review
Emergency department providers have become skilled at triaging patients with abdominal pain requiring surgical interventions. Abdominal pain mimics, medical conditions that cause the sensation of abdominal pain without abdominal abnormality, continue to puzzle the best physicians.
Topics: Abdominal Pain; Acute Disease; Chronic Disease; Emergency Service, Hospital; Humans
PubMed: 27133252
DOI: 10.1016/j.emc.2015.12.007 -
Deutsches Arzteblatt International Sep 2023
Topics: Humans; Abdominal Pain; Emergency Service, Hospital
PubMed: 37811846
DOI: 10.3238/arztebl.m2023.0163 -
Polski Przeglad Chirurgiczny Mar 2021Abdominal pain requires rapid diagnosis and treatment, especially in emergency circumstances. Sometimes the diagnosis of the disease cannot be accomplished with...
INTRODUCTION
Abdominal pain requires rapid diagnosis and treatment, especially in emergency circumstances. Sometimes the diagnosis of the disease cannot be accomplished with laboratory and imaging methods, and an invasive procedure such as diagnostic laparoscopy may be required to obtain a diagnosis. Diagnostic laparoscopy is also performed therapeutically, but laparotomy is inevitable in some cases. The aim of the study is to evaluate the role of diagnostic laparoscopy in diagnosis and treatment and to retrospectively examine the factors that force the surgeon to perform a laparotomy.
MATERIAL AND METHODS
Patients over the age of 18 who underwent diagnostic laparoscopy in the general surgery clinic of Sakarya University Training and Research Hospital between January 2013 and December 2019 were retrospectively evaluated. Patients under 18 years of age and patients diagnosed before surgery were excluded. Demographic data of the patients, whether there was a conversion from laparoscopy to laparotomy, postoperative morbidity, and mortality were recorded.
RESULTS
The data of 347 patients in total were evaluated retrospectively between the specified dates. 216 of the patients were previously diagnosed, laparoscopic procedures performed for staging purposes and they were not included in the study. The remaining 131 patients were included in the study. 68 of the patients were women and 63 were men. 79.4% of the patients were diagnostic laparoscopies performed due to emergency circumstances, and 20.6% for abdominal pain evaluation. While the procedure was concluded laparoscopically in 64.9% of the patients, the operation was continued by performing laparotomy in 35.1%.
CONCLUSION
Despite the increase in the variety and frequency of use of imaging modalities, a laparoscopic intervention is an essential approach in both diagnosis and treatment when the diagnosis is doubtful, especially in emergency cases in appropriate cases.
Topics: Abdomen; Abdominal Pain; Adolescent; Adult; Female; Humans; Laparoscopy; Laparotomy; Male; Retrospective Studies
PubMed: 33949333
DOI: 10.5604/01.3001.0014.8220 -
The Surgical Clinics of North America Dec 2023Early primary assessment and abdominal examination can often be enough to triage the patient with abdominal pain into those with less severe underlying pathologic... (Review)
Review
Early primary assessment and abdominal examination can often be enough to triage the patient with abdominal pain into those with less severe underlying pathologic condition from those with more acute findings. A focused history of the patient can then allow the clinician to develop their differential diagnosis. Once the differential diagnoses are determined, diagnostic imaging and laboratory findings can help confirm the diagnosis and allow for expeditious treatment and intervention.
Topics: Humans; Emergencies; Abdominal Pain; Diagnosis, Differential
PubMed: 37838455
DOI: 10.1016/j.suc.2023.05.010 -
Radiology Jul 2022A 45-year-old woman presented to the emergency department with acute worsening of prolonged unexplained nausea, nonbilious vomiting, and mild upper abdominal pain of 4...
A 45-year-old woman presented to the emergency department with acute worsening of prolonged unexplained nausea, nonbilious vomiting, and mild upper abdominal pain of 4 years duration. Her bowel habits were regular, and there was no history of diarrhea or fresh or altered blood in her stool. On further inquiry, there was no history of facial flushing, excessive diaphoresis, or asthmalike symptoms. Her history was unrevealing; in particular, there was no history of known malignancy. On clinical examination, her vital signs were stable. The abdomen was soft, with no focal tenderness or palpable mass. Routine blood investigations, including complete blood counts, and liver, kidney, and thyroid function tests yielded results that were within normal limits. Her 5-hydroxyindoleacetic acid and chromogranin A levels were not elevated. Initial evaluation with contrast-enhanced CT of the abdomen and pelvis was performed. Subsequently, an indium 111 octreotide scan was performed at the recommendation of the radiologist 1 month after CT (Figs 1, 2).
Topics: Abdomen; Abdominal Pain; Emergency Service, Hospital; Female; Humans; Middle Aged; Pelvis
PubMed: 35727713
DOI: 10.1148/radiol.210250 -
Current Opinion in Pediatrics Jun 2023Point-of-care ultrasound (POCUS) has various diagnostic and therapeutic applications in the pediatric acute care setting that have an impact on clinical outcomes. (Review)
Review
PURPOSE OF REVIEW
Point-of-care ultrasound (POCUS) has various diagnostic and therapeutic applications in the pediatric acute care setting that have an impact on clinical outcomes.
RECENT FINDINGS
POCUS can improve diagnostic efficiency and expedite management in pediatric patients who present to the emergency department with common complaints such as respiratory distress, abdominal pain, shock, and pain.
SUMMARY
Rapid advancements in POCUS have allowed it to become a powerful tool in pediatric care. As the clinical applications of ultrasound diversify, research is needed to evaluate impacts on healthcare outcomes, delivery, and costs.
Topics: Child; Humans; Point-of-Care Systems; Ultrasonography; Emergency Service, Hospital; Abdominal Pain
PubMed: 36974449
DOI: 10.1097/MOP.0000000000001244 -
Indian Journal of Pediatrics Jan 2018Abdominal pain is one of the common symptoms reported by children in urgent care clinics. While most children tend to have self-limiting conditions, the treating... (Review)
Review
Abdominal pain is one of the common symptoms reported by children in urgent care clinics. While most children tend to have self-limiting conditions, the treating pediatrician should watch out for underlying serious causes like intestinal obstruction and perforation peritonitis, which require immediate referral to an emergency department (ED). Abdominal pain may be secondary to surgical or non-surgical causes, and will differ as per the age of the child. The common etiologies for abdominal pain presenting to an urgent care clinic are acute gastro-enteritis, constipation and functional abdominal pain; however, a variety of extra-abdominal conditions may also present as abdominal pain. Meticulous history taking and physical examination are the best tools for diagnosis, while investigations have a limited role in treating benign etiologies.
Topics: Abdominal Pain; Ambulatory Care; Child; Humans; Physical Examination
PubMed: 28913814
DOI: 10.1007/s12098-017-2447-5