The Benefit of Further Tests for Patients Presenting to the Emergency Department with Non-Specific Abdominal Pain

ABSTRACT

PURPOSE: Acute abdominal pain is the most common cause of visits to the emergency department (ED). Among these visits, 30% of patients have non-specific abdominal pain (NSAP). Although the actual number of such patients is large, there are few studies of NSAP. Our report is about the usefulness of results from additional diagnostic tests for patients who have NSAP. METHODS: Subjects in our study were patients who presented at our ED between January 1, 2007 and December 31,2008 with NSAP. We retrospectively investigated the relevance of several factors including general patient characteristic, associated symptoms, pain site, existence of tenderness, and whether additional diagnostic tests were done. RESULTS: A total of 470 patients visited our ED during the study period and 148 of them had additional tests. Among the 148 patients who had additional tests, 48 had an important change in their treatment plan. Abdominal-pelvic computed tomography scans were a most useful tool in plan change (in 37 patients). Diseases that changed the treatment plan included fatal diseases such as abdominal aortic dissection and pan-peritonitis. CONCLUSION: Among patients with NSAP, carrying out of additional diagnostic tests led to important changes in the treatment plan. Abdominal-pelvic CT scans were a useful diagnostic tool. Therefore, close observation of NSAP patients is necessary and it is clinically useful to carry out additional diagnostic tests to see if the patient's symptoms and signs are changing.