Pathology is common in subsequent visits after admission for non-specific abdominal pain

Dan Med J. 2019 Jul;66(7):A5549.


Introduction: Although not supported by evidence, there may be a risk of overlooking pathological findings at patients' return visit after emergency admission for non-specific abdominal pain (NSAP). The primary aim of this study was to evaluate the risk of missed acute pathology in patients primarily discharged with NSAP and re-admitted within three months.

Methods: This was a retrospective review of hospital records within a three-month period (1 September-30 November, 2014) in a university hospital with unrestricted referral of abdominal emergency patients. Patients fulfilling the criteria for NSAP were included in the study.

Results: Among the 1,474 patients admitted with acute abdominal pain, 390 (26%) were discharged with NSAP; 16% of the patients who were discharged with NSAP were re-admitted for abdominal pain. At their return visit, 39% received a verified specific diagnosis, corresponding to 6% of all patients with the NSAP diagnosis. A total of 40% of the early re-admissions of patients with NSAP were related to the biliary tract (cholelithiatis, cholangitis and cholecystitis). Co-morbidity, nausea, vomiting and increased white blood cell count at the primary admission were significantly associated with a risk of missing a specific diagnosis (p < 0.05).

Conclusions: This study found that only 6% of the patients who were admitted for acute abdominal pain and were discharged with no diagnosis had a somatic condition. However, risk of pathological findings at the return visit was relatively high among patients discharged with NSAP.

Funding: none.

Trial registration: not relevant.

MeSH terms

  • Abdomen, Acute / diagnosis*
  • Abdomen, Acute / etiology
  • Abdomen, Acute / therapy
  • Abdominal Pain / diagnosis*
  • Abdominal Pain / etiology
  • Abdominal Pain / therapy
  • Adult
  • Denmark
  • Diagnosis, Differential
  • Emergency Service, Hospital / statistics & numerical data*
  • Female
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Patient Discharge / statistics & numerical data*
  • Physical Examination
  • Recurrence
  • Referral and Consultation
  • Retrospective Studies