Acute Abdominal Pain Management in the Emergency Department: Surgical or Non-Surgical Abdominal Pain

Abstract

Objective: In this study, it was aimed to compare surgical (SAP) and non-surgical abdominal pain (NSAP) in patients admitted to the emergency department (ED) with abdominal pain. Materials and Methods: This study was carried out prospectively with 200 patients with SAP and NSAP. The demographic characteristics, clinical presentations, laboratory analyzes, imaging methods, consultations and patient care costs of the patients were examined. Results: The mean age of the study group was 50.8±20.1 years and 52% of the patients were found to have SAP. In SAPcases, patients aged 75 years and above were in the first place, sensitivity-defense and rebound association and white blood cell elevation with an average of 15.27±4.10 thousand / UL were detected in physical examination. It was determined that the percentage of agreement between the preliminary diagnoses and laboratory findings made after the history and physical examination and evaluation by the AS physicians and the final diagnoses made after the radiological imaging methods was 71.7. It was found that the duration of stay in the ED and the cost were high in cases with SAP, elderly patients and those who requested consultation. Conclusion: Anamnesis and physical examination should definitely be done in patients who apply to AD with abdominal pain, and advanced imaging methods should be requested in the early period, especially in patients with SAP in order to accelerate the process and reduce costs. However, additional studies are needed to support this result.

Keywords

• Abdominal pain
• emergency service
• surgery
• cost

Acil Serviste Akut Karın Ağrısı Yönetimi: Cerrahi Ya Da Cerrahi Olmayan Karın Ağrıları

Öz

Amaç: Bu çalışmada acil servise (AS) karın ağrısı nedeni ile başvuran hastalarda cerrahi (CNKA) ve cerrahi nedenli olmayan karın ağrılarının (CNOKA) karşılaştırılması amaçlanmıştır. Materyal ve Metod: Bu çalışma prospektif olarak CNKA ve CNOKA olan 200 hasta ile gerçekleştirildi. Hastaların demografik özellikleri, klinik prezantasyonları, laboratuvar analizleri, görüntüleme yöntemleri, konsültasyonlar ve hasta bakım maliyetleri incelenmiştir. Bulgular: Çalışma grubunun ortalama yaşı 50,8±20,1 yıl ve hastaların %52’sinin CNKA’sı olduğu tespit edildi. CNKA olgularda 75 yaş ve üzeri hastaların ilk sırada yer aldığı, fizik muayenede hassasiyet-defans ve rebound birlikteliği ve ortalama 15,27±4,10 bin/UL ile beyaz küre yüksekliği tespit edildi. AS doktorlarınca öykü ve fizik muayene ile değerlendirme sonrasında konulan ön tanıları ve laboratuvar bulguları ile radyolojik görüntüleme yöntemleri sonrasında konulan son tanıların uyum yüzdesinin 71,7 olduğu saptandı. CNKA’lı olgularda, yaşlı hastalarda ve konsültasyon istenenlerde AS kalış süresi ve maliyetin yüksek olduğu saptandı. Sonuç: AS’lere karın ağrısı ile başvuran hastalarda anamnez ve fizik muayene mutlaka yapılmalı, sürecin hızlandırılması ve maliyetlerin azaltılmasına yönelik olarak özellikle CNKA düşünülen hastalarda ileri görüntüleme yöntemleri erken dönemde istenmelidir. Ancak bu sonucu destekleyecek ilave çalışmalar yapılmasına ihtiyaç vardır.

Anahtar Kelimeler

• Acil servis
• cerrahi
• karın ağrısı
• maliyet

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