L'addome acuto: esperienza su 196 casi consecutivi

The Authors studied 196 consecutive emergency admissions to their unit with a diagnosis of non-traumatic acute abdomen. The data were analysed in order to evaluate the demographic data, the diagnostic procedures performed and treatments administered, and the reliability of the admission diagnosis in comparison with the final diagnosis. During the study period acute abdomen emergencies amounted to 7% of the total admissions to the unit. Laboratory tests and abdominal ultrasonography were the most frequently used diagnostic tools, followed by plain film of the abdomen and CT scans, the latter being used in a distinctly lower number of cases. Seventy patients out of 196 (35.7%) underwent an emergency surgical procedure. The most frequently reported disease was acute appendicitis. Sixty-one of the subjects (31.1 %) with acute abdomen were successfully treated conservatively while 65 (33.2%) were diagnosed as being affected by non-splanchnic diseases, and thus categorised as cases of false acute abdomen. The Authors conclude that the diagnostic work-up for acute abdomen always needs a precise clinical history and a complete physical examination, but in some instances the support of widely available facilities, such as plain x-rays, ultrasonography, or CT scans can help to avoid useless surgical procedures or, conversely, potentially dangerous delays in administering treatment.