Clinical Presentations and Operative Management of Non Traumatic Acute Pain Abdomen- A Prospective Interventional Study from Jorhat, Assam, India

Abstract

Introduction: Non traumatic acute abdominal pain is a very common reason for patients’ visit to the Emergency Department and remains a challenging task for general surgeons in terms of appropriate diagnosis as well as management in a timely manner. Aim: To evaluate the clinical presentations, the operative management and the post-operative outcome of patients presented with non-traumatic acute pain abdomen. Materials and Methods: A hospital-based prospective interventional study was done in 250 patients presenting with non-traumatic acute pain abdomen to the Emergency Department of General Surgery, Jorhat Medical College and Hospital, Jorhat, Assam, India, from June 2021 to May 2022. Demographic profile, detailed history physical examination, operative managements and the outcome were noted. Results: Out of 250 patients with non-traumatic acute pain abdomen who underwent operative intervention, most affected age group was 2nd-4th decade of life, comprising 165 (66%) patients. A total of 167 (66.80%) were males. Most common presenting symptom besides pain abdomen was nausea, seen in 172 (68.80%) cases. Most common clinical sign besides tenderness was abdominal muscle guarding, seen in 220 (88%) cases. Acute appendicitis was the most common aetiology with 129 (51.60%) patients and emergency open appendicectomy was the most common surgical procedure performed. Most common post-operative complication was surgical site infection, seen in 57 (22.80%) cases. Mortality rate was 3.60% (9 deaths). Conclusion: As most acute pain abdomen invariably present with surgical emergency and varied aetiology, the complexity for imparting the most appropriate treatment is increased. Hence, surgeons in the emergency department need to be wellversed in assessing the patients right from taking of proper history, clinical correlation of symptoms to elicitation of signs, assisted with most readily available investigations, to arrive at a prompt diagnosis to provide appropriate surgical intervention at the earliest.