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Evaluation of Female Patients of Childbearing Age Who Applied to the Emergency Medicine Deparment with Abdominal Pain

Yıl 2025, Cilt: 7 Sayı: 2, 1 - 6, 01.09.2025
https://doi.org/10.55994/ejcc.1715030

Öz

Objective: Abdominal pain, which has etiological diversity, is associated with an increasing number of patients in emergency departments. Early recognition of its life-threatening causes is important. This study aims to evaluate the diagnoses of female patients of reproductive age who presented with non-traumatic abdominal pain.
Material and Methods: A prospective, cross-sectional study was conducted by including demographic and clinical information of women aged 18-50 years who presented to the emergency department of a tertiary hospital between March and September 2020 with non-traumatic abdominal pain.
Results: A total of 167 women with non-traumatic abdominal pain were included in the study. The most common presenting complaint was nausea-vomiting (41.3%), and the average duration of symptoms was 24 hours. Physical examination revealed abdominal tenderness in 74.9% of patients. During diagnosis, blood, urine, and stool tests were requested for 95.2% of patients, and imaging tests such as erect abdominal radiograph, ultrasound, magnetic resonanse, or computed tomography were requested for 61.7% of patients. The most common diagnosis was urinary tract infection, accounting for 24% of cases.
Conclusion: In addition to identifying the pathological condition causing abdominal pain, accompanying comorbidities and history of previous surgery must be investigated. Imaging tests play a crucial role in reaching the correct diagnosis. However, they also seen as a means of reducing emergency department overcrowding, hospitalization, and the need for surgical treatment.

Kaynakça

  • Ibrahim NA, Oludara MA, Ajani A, Mustafa I, Balogun R, Idowu O, et al. Non-trauma surgical emergencies in adults: Spectrum, challenges and outcome of care. Ann Med Surg (Lond) 2015; 4(4): 325-30.
  • Cartwringt SL, Knudson MP. Evaluation of acute abdominal pain in adults. Am Fam Physician 2008; 77(7): 971-8.
  • Ralls PW, Balfe DM, Bree RL, DiSantis DJ, Glick SN, Levine MS, et al. Evaluation of acute right lower quadrant pain. American College of Radiology. ACR Appropriateness Criteria. Radiology 2000; 215: 159-66.
  • Lameris W, Van Randen A, Dijkgraaf MG, Bossuyt PM, Stoker J, Boermeester MA. Optimization of diagnostic imaging use in patients with acute abdominal pain (OPTIMA): Design and rationale. BMC Emerg Med 2007; 7: 9.
  • Cervellin G, Mora R, Ticinesi A, Meschi T, Comelli I, Fausto C, et al. Epidemiology and outcomes of acute abdominal pain in a large urban Emergency Department: retrospective analysis of 5340 cases. Ann Transl Med 2016; 4(19): 362.
  • Mjema KM, Sawe HR, Kulola I, Mohamed AS, Sylvanus E, Mfinanga JA, et al. Aetiologies and outcomes of patients with abdominal pain presenting to an emergency department of a tertiary hospital in Tanzania: a prospective cohort study. BMC Gastroenterol 2020; 20: 173.
  • Smith-Bindman R, Miglioretti DL, Johnson E, Lee C, Feigelson HS, Flynn M, et al. Use of diagnostic imaging studies and associated radiation exposure for patients enrolled in large integrated health care systems, 1996-2010. JAMA 2012; 307(22): 2400-9.
  • Öncül MV, Dağar S, Emektar E, Çorbacıoğlu ŞK, Aytar H, Çevik Y. Effects of systemic inflammatory parameters on mortality in elderly patients admitted to emergency department with abdominal pain. ƒ∞stanbul Med J 2019; 20(2): 125-9.
  • Reynolds TA, Mfinanga JA, Sawe HR, Runyon MS, Mwafongo V. Emergency care capacity in Africa: a clinical and educational initiative in Tanzania. J Public Health Policy 2012; 33(S1): S126-S137.
  • Dündar ZD, Ayrancı MK. Evaluation of geriatric patients admitted to emergency department with a complaint of abdominal pain in terms of demographic characteristics and prognosis. Selcuk Med J 2021; 37(1): 45-51.
  • Shian B, Larson ST. Abdominal wall pain: clinical evaluation, differential diagnosis, and treatment. American family physician 2018; 98(7): 429-36.
  • Laurell H, Hansson LE, Gunnarsson U. Diagnostic pitfalls and accuracy of diagnosis in acute abdominal pain. Scand J Gastroenterol 2006; 41: 1126-31.
  • Lameris W, van Randen A, van Es HW, van Heesewijk JPM, van Ramshorst B, Bouma WH, et al. Imaging strategies for detection of urgent conditions in patients with acute abdominal pain: diagnostic accuracy study. BMJ 2009; 338: b2431.
  • Medford-Davis L, Park E, Shlamovitz G, Suliburk J, Meyer AND, Singh H. Diagnostic errors related to acuted to acute abdominal pain in the emergency department. Emerg Med J 2016; 33(4): 253-9.
  • Shaish H, Ream J, Huang C, Troost J, Gaur S, Chung R, et al. Diagnostic accuracy of unenhanced computed tomography for evaluation of acute abdominal pain in the emergency department. JAMA surgery 2023; 158(7): e231112.
  • Rosen MP, Siewert B, Sands DZ, Bromberg R, Edlow J, Raptopoulos V. Value of abdominal CT in the emergency department for patients with abdominal pain. Eur Radiol 2003; 13: 418-24.
  • Gans SL, Pols MA, Stoker J, Boermeester MA, expert steering group. Guideline for the diagnostic pathway in patients with acute abdominal pain. Dig Surg 2015; 32 (1): 23-31.
  • Caporale N, Morselli-Labate AM, Nardi E, Cogliandro R, Cavazza M, Stanghellini V. Acute abdominal pain in the emergency department of a university hospital in Italy. United European Gastroenterol J 2016; 4(2): 297-304.
  • Flasar MH, CrossR, Goldberg E. Acute abdominal pain. Prim Care 2006; 33(3): 659-84.
  • Lewis LM, Banet GA, Blanda M, Hustey FM, Meldon SW, Gerson LW. Etiology and clinical course of abdominal pain in senior patients: a prospective, multicenter study. J Gerontol A Biol Sci Med Sci 2005; 60(8): 1071-6.
  • Chanana L, Jegaraj MA, Kalyaniwala K, Yadav B, Abilash K. Clinical profile of non-traumatic acute abdominal pain presenting to an adult emergency department. Journal of family medicine and primary care 2015; 4(3): 422-5.
  • Driscoll PA, Vincent CA, Servant CJ, Audley RJ. Use of advisers in the diagnosis and management of abdominal pain in accident and emergency department. Br J Surg 1988; 75(12): 1173-5.
  • Türker ŞK, Beceren NG, Yolcu S, Armağan HH, Tomruk Ö. Acil servisimize bir yıl süreyle başvuran travma dışı erişkin karın ağrılı hastaların incelenmesi. Genel Tıp Derg. 2015;25:1-7.

Acil Tıp Kliniğine Karın Ağrısı ile Başvuran Doğurganlık Çağındaki Kadın Hastaların Değerlendirilmesi

Yıl 2025, Cilt: 7 Sayı: 2, 1 - 6, 01.09.2025
https://doi.org/10.55994/ejcc.1715030

Öz

Amaç: Etiyolojik olarak çeşitlilik gösteren karın ağrısı, acil servislerde giderek artan hasta sayısı ile ilişkilidir. Yaşamı tehdit eden nedenlerinin erken tanınması önemlidir. Bu çalışmada travmatik olmayan karın ağrısı ile başvuran üreme çağındaki kadın hastaların tanılarının değerlendirilmesi amaçlandı.
Gereç ve Yöntemler: Mart-Eylül 2020 tarihleri arasında üçüncü basamak bir hastanenin acil servisine travmatik olmayan karın ağrısı ile başvuran 18-50 yaş arası kadınların demografik ve klinik bilgileri de dahil edilerek prospektif, kesitsel bir çalışma yapıldı.
Bulgular: Travmatik olmayan karın ağrısı olan toplam 167 kadın çalışmaya dahil edildi. En sık başvuru şikayeti bulantı-kusma (%41.3) olup, semptomların ortalama süresi 24 saatti. Fizik muayenede hastaların %74.9'unda abdominal hassasiyet saptandı. Tanı sırasında hastaların %95,2'sine kan, idrar ve dışkı, %61,7'sine ise ayakta batın grafisi, ultrason, manyetik rezonans veya bilgisayarlı tomografi gibi görüntüleme tetkikleri istendi. En sık tanı idrar yolu enfeksiyonu idi ve vakaların %24'ünü oluşturuyordu.
Sonuç: Karın ağrısına neden olan patolojik durumun belirlenmesine ek olarak, eşlik eden komorbiditeler ve geçirilmiş cerrahi öyküsü araştırılmalıdır. Görüntüleme testleri doğru tanıya ulaşmada çok önemli bir rol oynar. Bununla birlikte, acil servisteki aşırı kalabalığı, hastaneye yatışları ve cerrahi tedavi ihtiyacını azaltmanın bir yolu olarak da görülüyorlar.

Kaynakça

  • Ibrahim NA, Oludara MA, Ajani A, Mustafa I, Balogun R, Idowu O, et al. Non-trauma surgical emergencies in adults: Spectrum, challenges and outcome of care. Ann Med Surg (Lond) 2015; 4(4): 325-30.
  • Cartwringt SL, Knudson MP. Evaluation of acute abdominal pain in adults. Am Fam Physician 2008; 77(7): 971-8.
  • Ralls PW, Balfe DM, Bree RL, DiSantis DJ, Glick SN, Levine MS, et al. Evaluation of acute right lower quadrant pain. American College of Radiology. ACR Appropriateness Criteria. Radiology 2000; 215: 159-66.
  • Lameris W, Van Randen A, Dijkgraaf MG, Bossuyt PM, Stoker J, Boermeester MA. Optimization of diagnostic imaging use in patients with acute abdominal pain (OPTIMA): Design and rationale. BMC Emerg Med 2007; 7: 9.
  • Cervellin G, Mora R, Ticinesi A, Meschi T, Comelli I, Fausto C, et al. Epidemiology and outcomes of acute abdominal pain in a large urban Emergency Department: retrospective analysis of 5340 cases. Ann Transl Med 2016; 4(19): 362.
  • Mjema KM, Sawe HR, Kulola I, Mohamed AS, Sylvanus E, Mfinanga JA, et al. Aetiologies and outcomes of patients with abdominal pain presenting to an emergency department of a tertiary hospital in Tanzania: a prospective cohort study. BMC Gastroenterol 2020; 20: 173.
  • Smith-Bindman R, Miglioretti DL, Johnson E, Lee C, Feigelson HS, Flynn M, et al. Use of diagnostic imaging studies and associated radiation exposure for patients enrolled in large integrated health care systems, 1996-2010. JAMA 2012; 307(22): 2400-9.
  • Öncül MV, Dağar S, Emektar E, Çorbacıoğlu ŞK, Aytar H, Çevik Y. Effects of systemic inflammatory parameters on mortality in elderly patients admitted to emergency department with abdominal pain. ƒ∞stanbul Med J 2019; 20(2): 125-9.
  • Reynolds TA, Mfinanga JA, Sawe HR, Runyon MS, Mwafongo V. Emergency care capacity in Africa: a clinical and educational initiative in Tanzania. J Public Health Policy 2012; 33(S1): S126-S137.
  • Dündar ZD, Ayrancı MK. Evaluation of geriatric patients admitted to emergency department with a complaint of abdominal pain in terms of demographic characteristics and prognosis. Selcuk Med J 2021; 37(1): 45-51.
  • Shian B, Larson ST. Abdominal wall pain: clinical evaluation, differential diagnosis, and treatment. American family physician 2018; 98(7): 429-36.
  • Laurell H, Hansson LE, Gunnarsson U. Diagnostic pitfalls and accuracy of diagnosis in acute abdominal pain. Scand J Gastroenterol 2006; 41: 1126-31.
  • Lameris W, van Randen A, van Es HW, van Heesewijk JPM, van Ramshorst B, Bouma WH, et al. Imaging strategies for detection of urgent conditions in patients with acute abdominal pain: diagnostic accuracy study. BMJ 2009; 338: b2431.
  • Medford-Davis L, Park E, Shlamovitz G, Suliburk J, Meyer AND, Singh H. Diagnostic errors related to acuted to acute abdominal pain in the emergency department. Emerg Med J 2016; 33(4): 253-9.
  • Shaish H, Ream J, Huang C, Troost J, Gaur S, Chung R, et al. Diagnostic accuracy of unenhanced computed tomography for evaluation of acute abdominal pain in the emergency department. JAMA surgery 2023; 158(7): e231112.
  • Rosen MP, Siewert B, Sands DZ, Bromberg R, Edlow J, Raptopoulos V. Value of abdominal CT in the emergency department for patients with abdominal pain. Eur Radiol 2003; 13: 418-24.
  • Gans SL, Pols MA, Stoker J, Boermeester MA, expert steering group. Guideline for the diagnostic pathway in patients with acute abdominal pain. Dig Surg 2015; 32 (1): 23-31.
  • Caporale N, Morselli-Labate AM, Nardi E, Cogliandro R, Cavazza M, Stanghellini V. Acute abdominal pain in the emergency department of a university hospital in Italy. United European Gastroenterol J 2016; 4(2): 297-304.
  • Flasar MH, CrossR, Goldberg E. Acute abdominal pain. Prim Care 2006; 33(3): 659-84.
  • Lewis LM, Banet GA, Blanda M, Hustey FM, Meldon SW, Gerson LW. Etiology and clinical course of abdominal pain in senior patients: a prospective, multicenter study. J Gerontol A Biol Sci Med Sci 2005; 60(8): 1071-6.
  • Chanana L, Jegaraj MA, Kalyaniwala K, Yadav B, Abilash K. Clinical profile of non-traumatic acute abdominal pain presenting to an adult emergency department. Journal of family medicine and primary care 2015; 4(3): 422-5.
  • Driscoll PA, Vincent CA, Servant CJ, Audley RJ. Use of advisers in the diagnosis and management of abdominal pain in accident and emergency department. Br J Surg 1988; 75(12): 1173-5.
  • Türker ŞK, Beceren NG, Yolcu S, Armağan HH, Tomruk Ö. Acil servisimize bir yıl süreyle başvuran travma dışı erişkin karın ağrılı hastaların incelenmesi. Genel Tıp Derg. 2015;25:1-7.
Toplam 23 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Acil Tıp
Bölüm Original Articles
Yazarlar

Enes Güler 0000-0003-4926-0332

Özlem Bilir 0000-0001-9016-1665

Gökhan Ersunan 0000-0002-4523-0294

İsmail Ataş 0000-0001-6723-8564

Yayımlanma Tarihi 1 Eylül 2025
Gönderilme Tarihi 5 Haziran 2025
Kabul Tarihi 5 Ağustos 2025
Yayımlandığı Sayı Yıl 2025 Cilt: 7 Sayı: 2

Kaynak Göster

AMA Güler E, Bilir Ö, Ersunan G, Ataş İ. Evaluation of Female Patients of Childbearing Age Who Applied to the Emergency Medicine Deparment with Abdominal Pain. Eurasian Journal of Critical Care. Eylül 2025;7(2):1-6. doi:10.55994/ejcc.1715030