Evaluation of the patients with acute abdomen in the Department of emergency medicine

Abstract

Introduction: Acute abdomen(AA) is abdominal pathology, manifested by pain <1 week, which requires urgent medical attention. It can have intra- or extra-abdominal causes. Purpose: Analysis and comparison of the evaluation of the patient with AA in the DEM of Institute of Emergency Medicine with those of the institutional and international protocols. Material and methods: Institutional, national, Romanian, Japanese guidelines and observation sheets for patients with AA from 2019 were used. Results:We examined 1608 medical records with surgical AA, of which 1075 underwent surgical treatment (67%), 44 died postoperatively (3%). Hemodynamically unstable patients were resuscitated. Hemodynamically stable patients were examined clinically, paraclinically, taking into account age, sex. The objective examination consisted of the general, local evaluation, the vaginal,rectal touch. ALVORADO, Ohmann scores were useful in the diagnosis of acute appendicitis. Paraclinical investigation included: blood test, urinalysis, blood biochemistry, abdominal USG,thoracic and abdominal radiography, ECG, CT. The presumptive diagnosis was confirmed or denied by laparascopy. Conclusions:The evaluation of patients was made in accordance with national, institutional and international guidelines. Patients with false AA accounted for 33% and avoided surgery. The mortality in AA in IMSPIMU in 2019 was 3%, similar to the international level.