Acute abdominal pain in general practice: tentative diagnoses and handling

Figures & data

Table I.  Patients with acute abdominal pain in general practice: action taken by physician.

Handling by GP	n = 134
Acute referral to hospital	35
Medication (antibiotic, anti-ulcer/reflux drug, antiemetic, laxative, pain killer)	34
Referral for investigation, non-acute (X-ray, ultrasound, endoscopy)	19
Follow-up appointment by GP	14
Medical advice	3
Sick leave	2
Urethral catheter	1
No specific action taken	36
Total*	144

Note: *Ten patients were given two handlings.

Table II.  Patients with acute abdominal pain in general practice. Diagnoses and factors predictive for hospital admission related to handling by GP (n = 134).

Handling by GP	Diagnoses (n)	Pain duration < 24 h (n)	Rebound tenderness (n)
Acute referral to hospital (n = 35)	Appendicitis (16) Gyn. condition (4) Biliary tract problem (4) Ulcer disease (3) Other (8 – trauma, hernia, gastroenteritis, inflammatory bowel disease)	17	18
Medication (n = 34)	Urinary tract infection (6) Reflux/dyspepsia (4) Gastroenteritis (4) Constipation (3) Renal calculus (2) Diverticulitis (2) Other (7 – gallstone, menstrual pain, tonsillitis, ulcer disease)	6	1
Non-acute referral (n = 19)	Gallstone (3) Ulcer disease (3) Renal calculus (2) Cancer (2) Other (9 – bleeding, constipation, inflammatory bowel disease)	4	0
Follow-up appointment (n = 14)	Unspecific pain (4) Reflux/dyspepsia (3) Gynaecological problem (3) Gastroenteritis/diarrhoea (2) Other (2 – haemorrhoids, hepatitis)	2	1
No specific action (n = 36)	Gastroenteritis (8) Non-specific pain (7) Irritable bowel syndrome (5) Gynaecological problem (4) Diverticulitis (2) Other (10 – overeating, influenza, adverse drug effect, diverticulitis)	9	2