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Pathology is common in subsequent visits after admission for non-specific abdominal pain

Authors
Christine Ravn-Christensen1, Niels Qvist2, Morten Bay-Nielsen1 & Thue Bisgaard1 1) Gastro Unit, Surgical Section, Centre for Surgical Research (CHS), Hvidovre Hospital 2) Surgical Department A, Odense University Hospital, Denmark

Dan Med J 2019;66(7):A5549

ABSTRACT

INTRODUCTION: Although not supported by evidence,
there may be a risk of overlooking pathological findings at patients’ return visit after emergency admission for non-specific abdominal pain (NSAP). The primary aim of this study was to evaluate the risk of missed acute pathology
in patients primarily discharged with NSAP and re-admitted within three months.

METHODS: This was a retrospective review of hospital records within a three-month period (1 September-30 November, 2014) in a university hospital with unrestricted referral of abdominal emergency patients. Patients fulfilling the criteria for NSAP were included in the study.

RESULTS: Among the 1,474 patients admitted with acute abdominal pain, 390 (26%) were discharged with NSAP; 16% of the patients who were discharged with NSAP were re-admitted for abdominal pain. At their return visit, 39% received a verified specific diagnosis, corresponding to 6% of all patients with the NSAP diagnosis. A total of 40% of the early re-admissions of patients with NSAP were related to the biliary tract (cholelithiatis, cholangitis and cholecystitis). Co-morbidity, nausea, vomiting and increased white blood cell count at the primary admission were significantly associated with a risk of missing a specific diagnosis
(p < 0.05).

CONCLUSIONS: This study found that only 6% of the patients who were admitted for acute abdominal pain and were discharged with no diagnosis had a somatic condition. However, risk of pathological findings at the return visit was relatively high among patients discharged with NSAP.

FUNDING: none.

TRIAL REGISTRATION: not relevant.

Abdominal pain is one of the most common symptoms leading to acute hospital admission [1]. Approximately one third of patients admitted with abdominal pain are not diagnosed with any specific pathological condition but are discharged with a diagnosis of non-specific abdominal pain (NSAP) [2]. ...
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Dan Med J 2019;66(7):A5549
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