Abdominal Emergencies

Abdominal pain is a common presentation, delays in diagnosis and management can complicate the patient outcome.

Achieving the balance between safe and expedient assessment versus delay and over investigation is the key in managing abdominal pain presentations.

History Red Flags

Age>65

Immunocompromised (e.g. HIV, chronic steroid treatment, renal failure, transplant patients and cancer patients on chemotherapy)

Multiple comorbidities

Previous abdominal surgery

Cardiac disease (AF, IHD)

Alcoholism

Pregnancy

Nature of pain

Sudden onset

Severe at onset

Constant

Physical examination

Fever

Tachycardia, hypotension

Signs of shock

Rigid abdomen

Involuntary guarding

  • ATS recommendations: Patients with any of the RED flags listed above, minimum ATS category of 2. Patients with any of the other factors listed above should be allocated to a mimimum ATS category of 3.

  • Early analgesia is important

  • Nurse initiated pathway: Example courtesy of Nepean Hospital.

  • An example of a disposition pathway is suggested. (Dr Rod Bishop, Nepean Hospital)

We present some clinical pathways which may be of use in guiding your practice and useful current links which will drive further searches.

Paediatric Abdominal Emergencies

This clinical tool deals with surgical abdominal emergencies in adults. Useful resources for management of paediatric abdominal emergencies can be found here.

Specific Conditions

Education Resources

Patient Factsheets

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