Early Identification and Management of Acute Abdomen in the Emergency Setting

Abstract

Acute abdomen is a life-threatening clinical presentation often found in the emergency department, and timely and correct identification crucial to prevent adverse consequences and optimize the patient’s prognosis. It forces ER physicians and general surgeons to make clinical decisions rapidly and in stressful situations. This research aimed to assess the diagnostic accuracy and decision-making processes for acute abdomen cases in the ER and identifying factors contributing to delays and strategies for improvement. This prospective clinical study included 100 patients aged between 20 to 50 years with acute abdomen attending the Al-Jumhorri Teaching Hospital, Mosul Iraq between December 2024 to March 2025. History and focused physical assessments, e-FAST, CT scans and laboratory tests were used in data collection. Duration of presentation before surgery was also measured in days and outcomes compared using statistical analysis in (spss28). The study showed that sensitivity and specificity of e-FAST were 85% and 90% respectively, and the specificity of CT imaging was better than that of e-FAST with 95% sensitivity and 95% specificity. The overall time from initial presentation to diagnosis averaged 2.5 hours, the total time to surgery 7.3 hours. Prolonged duration of operation for more than six hours had higher complications–25 %—and mortality– 5 %. Sources of delay incorporate ED boarding, imaging time, and diagnostic mistake. Each of the aspects of early intervention had a significant relationship with recovery rate of 85%.  In conclusion, timely diagnosis and surgical intervention are critical for managing acute abdomen. Accurate diagnosis and proper organization of an ER determines lower time intervals between injury and treatment and consequent rise of patients’ recovery rates and reduction of possible complications.