Association of Surgeons of the Netherlands Practice Guidelines of acute abdomen (some points of review)
💎10% of presentations at the Emergency Department are because of acute abdominal pain
💎Urgent causes require immediate treatment (within 24 h) to prevent complications
💎10% of presentations at the Emergency Department are because of acute abdominal pain
💎Urgent causes require immediate treatment (within 24 h) to prevent complications
💎Most common urgent causes are acute appendicitis, acute diverticulitis, and bowel obstruction
💎Sensitivity of medical history, physical examination, and laboratory values are higher for differentiating urgent from non-urgent conditions than for a specific diagnosis
💎Sensitivity of medical history, physical examination, and laboratory values are higher for differentiating urgent from non-urgent conditions than for a specific diagnosis
💎The inter-observer agreement between residents and staff is moderate for several aspects of medical history and physical examination (κ = 0.29–0.74)
💎The agreement between residents and emergency physicians for additional diagnostic imaging is sufficient (κ = 0.6)
💎The agreement between residents and emergency physicians for additional diagnostic imaging is sufficient (κ = 0.6)
💎Pelvic inflammatory disease (PID), extra uterine pregnancy, and ovarian torsion are considered urgent gynecological causes. ALWAYS TAKE IN MIND THEM
💎Outpatient re-evaluation of patients suspected of a nonurgent condition after clinical evaluation led to a change in diagnosis in 35%, a change in management in 19%, and a change from conservative to surgical treatment in 4.5% of patients
💎Higher C-Reactive Protein and WBC have higher specificity but lower sensitivity to distinguish an urgent condition
💎Only for bowel obstruction, conventional radiography has a higher sensitivity than clinical evaluation (74 vs. 57%).
💎Only for bowel obstruction, conventional radiography has a higher sensitivity than clinical evaluation (74 vs. 57%).
💎The conditional computed tomography strategy has a sensitivity of 94% and a specificity of 68%. first usg
💎Opioids do not decrease the diagnostic accuracy of physical examination, nor does it influence choices made in treatment, NSAID's has not yet been evaluated
💎Opioids do not decrease the diagnostic accuracy of physical examination, nor does it influence choices made in treatment, NSAID's has not yet been evaluated
💎Antibiotic treatment should be started within the first hour after recognition of sepsis
Dig Surg 2015;32:23–31 DOI: 10.1159/000371583
#SoMe4Surgery #FOAMed #surgery
Dig Surg 2015;32:23–31 DOI: 10.1159/000371583
#SoMe4Surgery #FOAMed #surgery
