scholarly journals Specific Management of Patients with Acute Abdomen during the COVID-19 Pandemic: A Surgical Perspective from Germany

2020 ◽  
Vol 36 (5) ◽  
pp. 417-420
Author(s):  
Florian Kühn ◽  
Matthias Klein ◽  
Henning Laven ◽  
Nikolaus Börner ◽  
Tobias Weinberger ◽  
...  
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Epithelial Cells ◽  
Acute Abdomen ◽  
Clinical Features ◽  
Clinical Case ◽  
Acute Abdominal Pain ◽  
Gastrointestinal Symptoms ◽  
Critical Conditions ◽  
Specific Management

During the current COVID-19 pandemic, the triage, assessment, and management of patients presenting to the emergency department with critical conditions has become ­challenging. The clinical features of COVID-19 are heterogeneous and subtle in many cases. They may easily be overlooked in the case of other acute diseases. Gastrointestinal symptoms are common in patients with COVID-19 as SARS-CoV-2 is able to enter gastrointestinal epithelial cells. However, these complaints can also be caused by a COVID-19-independent concomitant abdominal pathology. Therefore, patients with acute abdominal pain and fever need to be assessed very thoroughly. Based on a clinical case, we present our approach of managing emergency patients with acute abdomen and concomitant suspicion of ­COVID-19.

scholarly journals Routine Measurement of Serum Amylase in Acute Abdomen

2014 ◽  
Vol 52 (196) ◽  
pp. 982-985 ◽  
Author(s):  
Roshan Ghimire ◽  
Anurag Singh Thapa ◽  
Dimindra Karki ◽  
Dipendra Kumar Shrestha
Keyword(s):  
Emergency Department ◽  
Acute Pancreatitis ◽  
Abdominal Pain ◽  
Acute Abdomen ◽  
Serum Amylase ◽  
Acute Abdominal Pain ◽  
College Teaching ◽  
Amylase Level ◽  
Serum Amylase Level ◽  
Routine Measurement

Introduction: Acute abdominal pain is a common condition presenting to both the emergency department and surgical admission unit. Increase in serum amylase levels are found in much gastrointestinal pathology. Serum amylase level is consistently high in acute pancreatitis though high values are not pathognomonic of pancreatitis .The aim of this study to assess the level of serum amylase in various diseases presenting with acute abdominal pain and to evaluate the role of routine measurement of serum amylase in the screening of patient with acute abdominal pain for the diagnosis of acute pancreatitis in a prospective series. Methods: A prospective observational study was performed from 15th May 2014 – 15th Nov 2014 (6 months) at Department of Surgery of Kathmandu medical College Teaching Hospital; Kathmandu. All consecutive patients presented at emergency department and required admissions in surgical ward were included. A multivariate analysis was performed to assess the level of serum amylase in various diseases presenting with acute abdominal pain including acute pancreatitis. Results: Overall, 318 patients were included during a period of 6 months among them 48 patients were excluded. 34 cases (12.6 %) were diagnosed of acute pancreatitis. three cases (1.1%) of non pancreatic pathology with raised serum amylase level (> 1000 U\L). Conclusions: Routine assessment of serum amylase is helpful in excluding differential diagnosis of patient presenting with acute abdomen and this study identified serum amylase as a good screening tool if done in cases with clinical suspicion.  Keywords: acute abdominal pain; acute pancreatitis; serum amylase.

scholarly journals Lactobacillus Reuteri DSM 17938 (Limosilactobacillus reuteri) in Diarrhea and Constipation: Two Sides of the Same Coin?

Medicina ◽  
2021 ◽  
Vol 57 (7) ◽  
pp. 643
Author(s):  
Angela Saviano ◽  
Mattia Brigida ◽  
Alessio Migneco ◽  
Gayani Gunawardena ◽  
Christian Zanza ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Emergency Department ◽  
Abdominal Pain ◽  
Human Health ◽  
Bowel Disease ◽  
Chronic Constipation ◽  
Lactobacillus Reuteri ◽  
Current Knowledge ◽  
Gastrointestinal Symptoms ◽  
Inflammatory Bowel

Background and Objectives: Lactobacillus reuteri DSM 17938 (L. reuteri) is a probiotic that can colonize different human body sites, including primarily the gastrointestinal tract, but also the urinary tract, the skin, and breast milk. Literature data showed that the administration of L. reuteri can be beneficial to human health. The aim of this review was to summarize current knowledge on the role of L. reuteri in the management of gastrointestinal symptoms, abdominal pain, diarrhea and constipation, both in adults and children, which are frequent reasons for admission to the emergency department (ED), in order to promote the best selection of probiotic type in the treatment of these uncomfortable and common symptoms. Materials and Methods: We searched articles on PubMed® from January 2011 to January 2021. Results: Numerous clinical studies suggested that L. reuteri may be helpful in modulating gut microbiota, eliminating infections, and attenuating the gastrointestinal symptoms of enteric colitis, antibiotic-associated diarrhea (also related to the treatment of Helicobacter pylori (HP) infection), irritable bowel syndrome, inflammatory bowel disease, and chronic constipation. In both children and in adults, L. reuteri shortens the duration of acute infectious diarrhea and improves abdominal pain in patients with colitis or inflammatory bowel disease. It can ameliorate dyspepsia and symptoms of gastritis in patients with HP infection. Moreover, it improves gut motility and chronic constipation. Conclusion: Currently, probiotics are widely used to prevent and treat numerous gastrointestinal disorders. In our opinion, L. reuteri meets all the requirements to be considered a safe, well-tolerated, and efficacious probiotic that is able to contribute to the beneficial effects on gut-human health, preventing and treating many gastrointestinal symptoms, and speeding up the recovery and discharge of patients accessing the emergency department.

scholarly journals Imaging of non-traumatic acute abdominal pain in adults presenting to the emergency department

2016 ◽  
Vol 37 (3) ◽  
pp. 324-327 ◽  
Author(s):  
Mohamed Abd El Bagi ◽  
Badr Almutairi ◽  
Sami Alsolamy
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Acute Abdominal Pain

Analgesic Access for Acute Abdominal Pain in the Emergency Department Among Racial/Ethnic Minority Patients

Medical Care ◽  
2015 ◽  
Vol 53 (12) ◽  
pp. 1000-1009 ◽  
Author(s):  
Adil A. Shah ◽  
Cheryl K. Zogg ◽  
Syed Nabeel Zafar ◽  
Eric B. Schneider ◽  
Lisa A. Cooper ◽  
...  
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Ethnic Minority ◽  
Acute Abdominal Pain ◽  
Racial Ethnic

Unscheduled Revisits after Diagnosis of Abdominal Pain at Emergency Department, Mukdahan Hospital

2021 ◽  
Vol 104 (Suppl. 1) ◽  
pp. S40-S43
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Patient Care ◽  
Acute Abdominal Pain ◽  
Signs And Symptoms ◽  
Discharge System ◽  
Effective Discharge ◽  
Time Period ◽  
Pain Patients

Background: Abdominal pain is a common complaint for patients revisiting the Emergency Department (ED). Evaluating the cause of the revisit can improve the quality of ED patient care. Objective: We aimed to analyzed unscheduled revisits after diagnosis of abdominal pain at emergency department. Materials and Methods: In order to determine the characteristics of their abdominal pain and the causes for the revisits, the charts of 90 patients were reviewed. These patients had experienced acute abdominal pain and had returned to the Emergency Department within 48 hours after their initial treatment during the period between January 2019 and December 2019. Results: During that time period, 44,000 patients visited the ED. Of these, 90 patients (0.2%) with acute abdominal pain or related symptoms had revisited the ED within the following 48 hours. Most of these patients had been 20 to 60 years of age and had had no co-morbid diseases. Almost half of patient revisits had occurred during the evening shift (45.6%). There were 74% of these patients, who had been admitted to hospital for observation or for procedures. No in-hospital mortality was reported for this study. The signs and symptoms of abdominal pain in these patients had not been specific. The factors, which most often contributed to the ED revisits, had been inappropriate consultations and inappropriate discharges or advises. Conclusion: The majority of the acute abdominal pain patients, who revisited the ED within 48 hours, had been admitted. The most common cause of revisits had been inappropriate consultations and inappropriate discharges. Improving ED patient care can be managed by contributing to effective consultations and to establishing an effective discharge system for the ED. Keywords: Revisits, Emergency medicine department, Acute abdominal pain

scholarly journals Prevalence of pneumonia in children under 12 years of age who undergo abdominal radiography in the emergency department

CJEM ◽  
2007 ◽  
Vol 9 (05) ◽  
pp. 347-351 ◽  
Author(s):  
Valérie Homier ◽  
Colette Bellavance ◽  
Marianne Xhignesse
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Chest Radiograph ◽  
Chest Radiography ◽  
Acute Abdominal Pain ◽  
Tertiary Care ◽  
Abdominal Radiograph ◽  
Upper Respiratory Tract ◽  
Abdominal Radiography ◽  
X Ray

ABSTRACT Objective: Pneumonia is a well-known cause of acute abdominal pain in children. However, the utility of chest radiography in this setting is controversial. We sought to determine the prevalence of pneumonia in children under 12 years of age who had abdominal pain and underwent abdominal radiography when visiting an emergency department (ED). We also aimed to describe the signs and symptoms of children diagnosed with pneumonia in this context. Methods: We conducted a retrospective analysis of electronic data from ED visits to a tertiary care centre by children 12 years of age and under who were seen between June 1, 2001, and June 30, 2003, and who underwent both an abdominal and a chest radiograph during the same visit, or an abdominal x-ray at a first visit as well as a chest x-ray in the 10 days following the initial visit. Results: Of 1584 visits studied, 30 cases of pneumonia were identified, for a prevalence of 1.89% (95% confidence interval 1.22%–1.56%). If chest radiography had been limited to children who presented with fever, cough and symptoms of an upper respiratory tract infection (URTI), the diagnosis of pneumonia would have been missed in only 2/1584 visits (0.13%). Conclusion: Children aged 12 years and under presenting to the ED with acute abdominal pain and in whom an abdominal radiograph is requested need only undergo a chest radiograph in the presence of cough, fever or other symptoms of a URTI.

scholarly journals Randomized Trial of Intravenous Lidocaine Versus Hydromorphone for Acute Abdominal Pain in the Emergency Department

2019 ◽  
Vol 74 (2) ◽  
pp. 233-240 ◽  
Author(s):  
Elliott Chinn ◽  
Benjamin W. Friedman ◽  
Farnia Naeem ◽  
Eddie Irizarry ◽  
Freda Afrifa ◽  
...  
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Randomized Trial ◽  
Acute Abdominal Pain ◽  
Intravenous Lidocaine

scholarly journals Acute Abdomen in a Patient with Cancer Pain on Oxycodone

2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
Naomi Kishine ◽  
Atsunobu Tsunoda ◽  
Seiji Kishimoto ◽  
Tomohisa Shoko
Keyword(s):  
Abdominal Pain ◽  
Adverse Effects ◽  
Cancer Pain ◽  
Acute Abdomen ◽  
Pain Therapy ◽  
Acute Abdominal Pain ◽  
Colonic Obstruction ◽  
Abdominal Distension ◽  
Abrupt Increase ◽  
Cancer Pain Therapy

Opioids are a mainstay of treatment for moderate to severe cancer pain. At present, oxycodone has fewer adverse effects compared to morphine and is widely used for cancer pain therapy. The adverse effects of oxycodone are similar to morphine and include constipation, nausea, and sedation. However, acute abdominal pain is rarely seen. Here, we describe a cancer patient presenting with acute abdomen with stercoral diarrhea. A 54-year-old man with squamous cell carcinoma of the external auditory canal had been taking oxycodone for pain relief. The patient had taken oxycodone for several months and had never complained of either diarrhea or constipation. After an increase in the dosage of oxycodone, he complained of abdominal distension and constipation. After being administered a laxative, he complained of diarrhea and severe abdominal pain. He visited the emergency department and was diagnosed with acute colonic obstruction caused by severe constipation. He self-medicated with oxycodone at dosages of up to 180 mg/day, and this abrupt increase of oxycodone caused stercoral diarrhea. Finally, total blockage of stool developed, resulting in acute abdomen.

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