Background: Acute abdominal pain can be a diagnostic challenge even for experienced surgeons. Delayed diagnosis can lead to higher morbidity, mortality and increased costs. While readmission rate has been used to evaluate quality of surgical care, studies addressing the issue in emergency departments (ED) are rare. The role of emergency physicians in the care of patients with abdominal pain is increasing in many European countries, including Finland. It is not known whether this has an effect on the number of readmissions. Here we evaluate whether the increasing role of emergency physicians in examining patients presenting with abdominal pain has affected the rate of short-term revisits among patients with non-specific abdominal pain (NSAP).
Methods: We identified consecutive ED patients receiving a diagnosis of NSAP 1.1. 2015-31.12.2016 in the ED of Tampere University Hospital. Those revisiting the ED within 48 h were selected for further analysis. Data were obtained from electronic medical records. We compared the outcomes of those initially examined by surgeons and by emergency physicians.
Results: During the study period, 173,630 patients visited our ED, of whom 6.1% (n = 10,609) were discharged with a diagnosis of NSAP. Only 3.0% of patients revisited the ED, 0.7% required hospitalization and 0.06% immediate surgery. The short-term revisit rates among those originally examined by surgeons and by emergency physicians were similar, 2.8 and 3.2% respectively (p = 0.193).
Conclusions: The rate of short-term revisits in patients with NSAP was altogether low. The increasing role of emergency physicians in the care of acute abdominal patients did not affect the revisit rate.
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http://dx.doi.org/10.1186/s13049-020-00751-8 | DOI Listing |
BJOG
January 2025
Department of Public Health, Aarhus University, Aarhus, Denmark.
Objective: To build consensus on most important symptoms and related consequences for use in questionnaires to characterise individuals with suspected and confirmed endometriosis in the general population.
Design: A questionnaire of 107 symptoms and related consequences of endometriosis was collaboratively developed by patients, medical doctors and researchers and further assessed in a two-round e-Delphi study. Participants assessed the relevance of the symptoms, and a priori it was decided that 70% was the threshold for inclusion of a symptom.
Cureus
December 2024
Emergency Medicine, Nagasaki Harbor Medical Center, Nagasaki, JPN.
, a rare human pathogen, has limited clinical data. This case report presents a case of sepsis, pyelonephritis, and septic spondylitis treated successfully with ampicillin. An 82-year-old woman was hospitalized for acute pyelonephritis and sepsis, presenting with fever and abdominal pain.
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December 2024
Trauma and Acute Care Surgery, Northeast Georgia Medical Center Gainesville, Gainesville, USA.
Roux-en-Y gastric bypass (RYGB) is a common surgical treatment for morbid obesity, but rare complications involving the excluded gastric remnant can pose significant challenges. A 65-year-old female with a history of RYGB presented with sudden onset of left upper quadrant abdominal pain, bloating, nausea, and loss of appetite. Laboratory tests revealed leukocytosis.
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December 2024
Department of Surgery, Royal Oldham Hospital, Northern Care Alliance NHS Trust, Manchester, GBR.
Gallstone ileus (GSI) is a rare complication of gallstone disease. It occurs as a result of the passage of a stone from the biliary tract into the gastrointestinal tract via an abnormal pathway (bilio-enteric fistula). Chronic inflammatory processes result in gall bladder adhering and subsequently eroding into the intestines, leading to a fistula.
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December 2024
Department of Anatomy, Ganesh Shankar Vidyarthi Memorial Medical College, Kanpur, IND.
Purpose Hepatic abscesses remain a significant clinical challenge due to high morbidity and mortality. This research aims to examine the etiological spectrum, management approaches, clinical features, and results in hepatic abscesses in a tertiary care facility in northern India, emphasizing the distinctions among pyogenic liver abscesses (PLAs) and amoebic liver abscesses (ALAs). Methods This retrospective study was done at GSVM Medical College, Kanpur, analyzing 725 patients with hepatic abscesses over a 10-year period.
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