Clinical and etiological profile of acute abdomen in the green zone of the Emergency Department

Abstract

Background. Acute abdomen (AA) remains one of the most common and challenging emergencies encountered in medical practice in Emergency Department (ED). Prompt recognition and early treatment are crucial to reduce morbidity and mortality. This clinical entity encompasses a variety of pathologies requiring emergency surgery. Objective(s). Evaluation of the incidence, etiology, and therapeutic approach of acute abdomen cases registered in the green zone of the ED at the IEM, over a five-month period (1.01.2025-31.05.2025). Materials and methods. A prospective, descriptive study was conducted, which included 1987 adult patients (≥18) who presented in the green zone of the Emergency Department, IEM. Of these, 640 patients (32,2%) were diagnosed with acute abdomen. Clinicodemographic data, etiology, type of treatment and post-intervention evolution were analyzed. Results. Out of 1987 total ED visits in the green zone during the study period, 640 patients (32,2%) were diagnosed with acute abdomen. The mean age of the patients was 48,7 ± 15,3 years (range: 18–85 years) and the sex distribution was balanced (51,2% men, 48,8% women). The most common etiologies included: acute pancreatitis – 31%, acute appendicitis – 30%, acute lithiasic cholecystitis – 19%, intestinal obstruction – 18%, hollow organ perforation – 2%. All patients required hospitalization, with 42.3% undergoing emergency surgery. The mortality rate was 2.1%, primarily among patients with diffuse peritonitis, sepsis, or severe pancreatitis. Conclusion(s). Acute abdomen is an incidence in patients triaged in the green zone, indicating the need for careful clinical assessment and prompt intervention. Early recognition, effective management strengthening interdisciplinary collaboration contribute significantly to reducing morbidity and mortality.