Description

ABSTRACT

Background: Abdominal pain is a common complaint for patients seeking health care at emergency departments, estimated at 3.4 million per year in USA, where it is considered as a frequent and potentially high chief claim. The acute abdomen pain has no specificity with regard to its outcome. This is shown in the acute appendicitis, the commonest aetiology of acute abdomen pain. If treated correctly and on time, the outcome of acute appendicitis is usually good. Untreated on time, it may lead to perforation, generalized peritonitis and even to death. In our knowledge, there is no formal acute abdomen protocol or policy in the sub Saharan region at large and in Zambia and Lusaka in particular. Hence need of this pioneering work to be revised and adjusted with circumstances of time and area. Objective: The purpose of this study is an essay of establishing based on the University Teaching Hospital some guideline for the management of patients with acute abdomen pain in the setting and that might also assist physicians working under similar health facilities, at filter clinic, casualty and admitting rooms. Methods: It was a descriptive analytic study carried out in 2015 based on the two-year work of 5 general surgery units’ data, at the Lusaka UTH. The population study included all admitted patients to these 5 units for clinical diagnosis of AA, directly from casualty of admitting rooms or indirectly from other UTH units or firms. The data collections was done by the team following the questionnaire and entered in Excel spread sheet before being analysed by SSP. Discussion of the results was done and proposed protocols were written and read by a team member during wide regional conference for more discussions and adjustments. Results: The proposed protocols are given in texts, tables and figures. The orientation of the patient with AA is important to not missing out the time of operation of a SAC and the way to score each of them is shown. It is needed to regularly review these protocols to adjust them and to appreciate the impact of new non invasive investigations. As emphasized by many authors, an important component of guidelines utilization is the date of their publication and their current applicability to patient care.

 Keywords: Acute pain management, Abdomen, Spontaneous, Emergency, Resuscitation, Investigations, Patients’ orientation