A study of non traumatic acute abdomen in ESIC

Abstract

Background of study: Non traumatic acute abdomen is wide spectrum of disease with similar presentation. Diagnosis is often difficult because clinical features may be masked and diagnostic radiology is constrained. Management may be stratified based on surgeons preference and patient’s needs. Objectives: To study incidence, aetiology and pattern of clinical presentation of acute abdomen; To study the accuracy of clinical diagnosis. Materials and methods: A prospective study in a tertiary teaching hospital extended over 6 months ( September 2019- February 2020). Patients presenting with acute abdomen and requiring more than 24 hours of observation, or care as inpatients in the surgical wards were included.History, clinical examination andProvisional diagnosis was noted in proforma. Basic investigations like total leukocyte count, urine microscopy, X-ray erect abdomen were done in all patients.Diagnosis was made based on clinical and investigation findings and further confirmed at laparotomy in operated patients.The institution ethics committee approved the study. The data was analysed by Winks statistical software, evaluation version. Results: 605 eligible patients were picked up to participate in the study. 495 patients with surgical causes of acute abdomen were included for prospective study and analysis. 314 (63.4%) were managed operatively.Accuracy of clinical diagnosis based on history and physical examination supported by specific investigations was 87.27%. Conclusion: Patient presenting with acute abdominal pain has no anorexia, raised temperature, guarding, or rebound tenderness, leukocytosis and urinary abnormalities at presentation then he is less likely to need any surgical intervention irrespective of age, sex, pain duration and presence or absence of vomiting, bowel abnormalities or tenderness.