NP Medical News about acute abdominal pain; general practice

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Acute abdominal pain in general practice: tentative diagnoses and handling
Scandinavian Journal of Primary Health Care, 09/04/09

Brekke M et al. – The most frequent diagnosis was non–specific pain (20%), followed by gastroenteritis (13%), appendicitis (12%), ulcer disease (11%), gynaecological disease (9%), and urinary tract problems (7%). One–quarter of patients were sent home after clinical examination without any specific action taken. One–quarter were acutely admitted to hospital, and one–quarter were treated with medication. The rest was either referred for further investigations on a non–acute basis (14%) or given a follow–up appointment with the GP (10%). Suspected appendicitis was the strongest predictor for acute admission. Rebound tenderness on clinical examination as well as pain duration for 24 hours or less also independently predicted acute hospital admission. GPs face the challenge of meeting a wide and inhomogeneous spectre of complaints when dealing with patients with acute abdominal pain. Three–quarters of patients are taken care of in primary care.

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