Interdisciplinary Coordination in the Diagnosis and Management of Acute Abdomen: Radiological Assessment, Laboratory Correlation, and Administrative Support in Emergency Care
Abstract
Background: Acute abdominal pain is a common and challenging presentation in emergency medicine, encompassing a wide spectrum of conditions from benign, self-limiting issues to life-threatening surgical emergencies. Its diverse etiologies include inflammatory, obstructive, vascular, and infectious processes, making accurate and timely diagnosis critical.
Aim: This article aims to synthesize an interdisciplinary framework for the diagnosis and management of the acute abdomen, emphasizing the integration of clinical assessment, radiological imaging, laboratory correlation, and administrative support to optimize patient outcomes.
Methods: A comprehensive review of the evaluation process is presented, covering the pathophysiology of abdominal pain, systematic history-taking, and physical examination. The analysis details the strategic use of diagnostic tools, including point-of-care ultrasound, laboratory tests, and advanced cross-sectional imaging like CT scans, tailored to the pain's location and patient-specific risk factors.
Results: Successful management hinges on a structured, team-based approach. Rapid resuscitation, timely analgesia, and early surgical consultation are paramount for unstable patients. Diagnostic accuracy is greatly enhanced by correlating clinical findings with targeted imaging and lab results, allowing for the swift identification of time-sensitive conditions such as mesenteric ischemia, ruptured aortic aneurysm, and appendicitis.
Conclusion: The effective management of acute abdominal pain requires a coordinated, multidisciplinary effort. Disciplined clinical evaluation, guided by an understanding of pain mechanisms and supported by appropriate diagnostics, ensures that critical conditions are rapidly identified and treated, thereby reducing morbidity and mortality.
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References
Elhardello OA, MacFie J. Digital rectal examination in patients with acute abdominal pain. Emerg Med J. 2018 Sep;35(9):579-580.
Maleki Verki M, Motamed H. Rectus Muscle Hematoma as a Rare Differential Diagnosis of Acute Abdomen; a Case Report. Emerg (Tehran). 2018;6(1):e28.
Kaushal-Deep SM, Anees A, Khan S, Khan MA, Lodhi M. Primary cecal pathologies presenting as acute abdomen and critical appraisal of their current management strategies in emergency settings with review of literature. Int J Crit Illn Inj Sci. 2018 Apr-Jun;8(2):90-99.
Buel KL, Wilcox J, Mingo PT. Acute Abdominal Pain in Children: Evaluation and Management. Am Fam Physician. 2024 Dec;110(6):621-631.
Jamsheer F, Alsudairy N. Pulmonary Embolism Masquerading as Acute Abdominal Pain: A Rare and Challenging Diagnosis. Cureus. 2024 Nov;16(11):e74623.
Tsukamoto T, Kunimoto T, Kaizaki R. Gallbladder perforation causing local peritonitis in left upper abdomen: A case report. Int J Surg Case Rep. 2025 Jan;126:110772.
Wolfe JM, Lein DY, Lenkoski K, Smithline HA. Analgesic administration to patients with an acute abdomen: a survey of emergency medicine physicians. Am J Emerg Med. 2000 May;18(3):250-3.
Haider SM, Ashraf MN, Niaz K, Abbas MH, Rehman U. A Case Report of Drug-Induced Acute Gastric Necrosis. Cureus. 2024 Nov;16(11):e73696.
Marin Cuartas T, Nasri AF, Bollmann S. [Atypical spontaneous bacterial peritonitis linked to streptococcal toxic shock syndrome]. Dtsch Med Wochenschr. 2025 Jan;150(1-02):44-47.
Shahi R, Siddiqui NH, Khan IA, Bashar MA. Etiologies and Outcomes Following Duodenal Perforation in Acute Peritonitis: A Systematic Review. Cureus. 2024 Nov;16(11):e74707.
González García J, Cruz Hernandez BD, Pérez Solis LF, Pucheta Hernández NA, Trujillo Rodríguez JE, Martinez Bravo VM. Acute Gastric Necrosis Secondary to Mesenteric Ischemia: A Case Report and Literature Review. Cureus. 2024 Dec;16(12):e76680.
Binko MA, Andraska EA, Reitz KM, Handzel RM, Singh MJ, Sridharan ND, Chaer RA, Hager ES. The natural history of portal venous system aneurysms. J Vasc Surg Venous Lymphat Disord. 2024 Dec 27;:102163.
Sultana R, Noor S, Fawwad A, Abbasi N, Bashir R. Septic/unsafe abortion: a preventable tragedy. J Ayub Med Coll Abbottabad. 2012 Jul-Dec;24(3-4):154-6.
Li PH, Tee YS, Fu CY, Liao CH, Wang SY, Hsu YP, Yeh CN, Wu EH. The Role of Noncontrast CT in the Evaluation of Surgical Abdomen Patients. Am Surg. 2018 Jun 01;84(6):1015-1021.
Cervellin G, Mora R, Ticinesi A, Meschi T, Comelli I, Catena F, Lippi G. Epidemiology and outcomes of acute abdominal pain in a large urban Emergency Department: retrospective analysis of 5,340 cases. Ann Transl Med. 2016 Oct;4(19):362.
de Burlet K, Lam A, Larsen P, Dennett E. Acute abdominal pain-changes in the way we assess it over a decade. N Z Med J. 2017 Oct 06;130(1463):39-44.
Sabir F, Hanif S, Gardezi F, Saeed M, Bibi R, Haider S. Admission With Acute Abdomen: Presentation, Conditions Identified And Management Outcomes. J Ayub Med Coll Abbottabad. 2024 Jan-Mar;36(1):165-169.
Tseng YC, Lee MS, Chang YJ, Wu HP. Acute abdomen in pediatric patients admitted to the pediatric emergency department. Pediatr Neonatol. 2008 Aug;49(4):126-34.
Govender I, Rangiah S, Bongongo T, Mahuma P. A Primary Care Approach to Abdominal Pain in Adults. S Afr Fam Pract (2004). 2021 Mar 10;63(1):e1-e5.
Mahmood A, Abdul Rahman S, Chua SM, Abdelgawwad W. Small Bowel Obstruction as a Complication of Acute Pancreatitis. Cureus. 2024 Nov;16(11):e74800.
Gu Y, Lim HJ, Moser MA. How useful are bowel sounds in assessing the abdomen? Dig Surg. 2010;27(5):422-6.
Eskelinen M, Ikonen J, Lipponen P. Contributions of history-taking, physical examination, and computer assistance to diagnosis of acute small-bowel obstruction. A prospective study of 1333 patients with acute abdominal pain. Scand J Gastroenterol. 1994 Aug;29(8):715-21.
Leidi A, Saudan A, Soret G, Rouyer F, Marti C, Stirnemann J, Reny JL, Grosgurin O. Confidence and use of physical examination and point-of-care ultrasonography for detection of abdominal or pleural free fluid. A cross-sectional survey. Intern Emerg Med. 2022 Jan;17(1):113-122.
Sandeep C, Mallick, Mohanty AP. Clinical and Microbiological Profile of Patients with Acute Cholangitis in a Tertiary Care Center. J Assoc Physicians India. 2023 Jan;71(1):1.
Feuerstein JD, Falchuk KR. Diverticulosis and Diverticulitis. Mayo Clin Proc. 2016 Aug;91(8):1094-104.
Nienaber CA, Fattori R, Mehta RH, Richartz BM, Evangelista A, Petzsch M, Cooper JV, Januzzi JL, Ince H, Sechtem U, Bossone E, Fang J, Smith DE, Isselbacher EM, Pape LA, Eagle KA., International Registry of Acute Aortic Dissection. Gender-related differences in acute aortic dissection. Circulation. 2004 Jun 22;109(24):3014-21.
Pape LA, Awais M, Woznicki EM, Suzuki T, Trimarchi S, Evangelista A, Myrmel T, Larsen M, Harris KM, Greason K, Di Eusanio M, Bossone E, Montgomery DG, Eagle KA, Nienaber CA, Isselbacher EM, O'Gara P. Presentation, Diagnosis, and Outcomes of Acute Aortic Dissection: 17-Year Trends From the International Registry of Acute Aortic Dissection. J Am Coll Cardiol. 2015 Jul 28;66(4):350-8.
Yang XF, Liu JL. Acute incarcerated external abdominal hernia. Ann Transl Med. 2014 Nov;2(11):110.
Lee SY, Bhaduri M. Cecal volvulus. CMAJ. 2013 May 14;185(8):684.
Sathiyamoorthi N, Maduranga LSKKP, Thomas S, Vyas V. Porcelain appendix: a rare mimicker of the acute abdomen. BMJ Case Rep. 2024 Dec 18;17(12)
Pearson J, Greminger A, Onello E, Stover S. Teaching the Evaluation of Female Pelvic Pain: A Hands-On Simulation to Reinforce Exam Skills and Introduce Transvaginal Ultrasound. MedEdPORTAL. 2021 Jan 25;17:11080.
Segura Grau A, Mejías Gil M, Román Garrido M. [Use of clinical ultrasound in primary care: Acute abdominal pain]. Semergen. 2024 Dec;50(9):102369.
Lee CH, Leu HS, Hu TH, Liu JW. Splenic abscess in southern Taiwan. J Microbiol Immunol Infect. 2004 Feb;37(1):39-44.
Brewer J, Conger H, Rash R. The erector spinae block: a novel approach to pain management in acute appendicitis. Ultrasound J. 2022 Jul 26;14(1):30.
Macaluso CR, McNamara RM. Evaluation and management of acute abdominal pain in the emergency department. Int J Gen Med. 2012;5:789-97.
Kumar D, Garg I, Sarwar AH, Kumar L, Kumar V, Ramrakhia S, Naz S, Jamil A, Iqbal ZQ, Kumar B. Causes of Acute Peritonitis and Its Complication. Cureus. 2021 May 28;13(5):e15301.
Kakamba JB, Wadhwani S, Bangolo AI, Ngandu A, Bepouka B, Mbiso DL, Opanga JK, Basolua JN, Kakamba S, Siasia A, Bayauli PM, Weissman S, Wadhwani N, M'Buyamba-Kabangu JR. An Unusual Case of Acute Abdomen With Jaundice. Cureus. 2024 Dec;16(12):e76155.
Mishra C, Omar KO. Internal Hernia: An Uncommon and Often-Missed Differential Diagnosis of Abdominal Pain. Cureus. 2024 Dec;16(12):e75801.
Nakashima T, Miyamoto K, Shimokawa T, Kato S, Hayakawa M. The Association Between Sequential Organ Failure Assessment Scores and Mortality in Patients With Sepsis During the First Week: The JSEPTIC DIC Study. J Intensive Care Med. 2020 Jul;35(7):656-662.
Pucher PH, Carter NC, Knight BC, Toh S, Tucker V, Mercer SJ. Impact of laparoscopic approach in emergency major abdominal surgery: single-centre analysis of 748 consecutive cases. Ann R Coll Surg Engl. 2018 Apr;100(4):279-284.
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Copyright (c) 2024 Jubarah Ali Jaber Khiswi, Albandri Hamood Hassan Alhazmi, Ahmad Nasser Alrashidi, Roaa Ahmed Dwoiri, Khaled Mohammed Al-Kharif, Hamad Fahd Al-Tarfan, Khalid Mohsen M Saabi, Sarah Ahmed Arif, Khalid Abdullah Ali Homdi, Fuad Moraia Mohammed Hakami, Nadia Mohammed Hassan Khormi, Zaid Honoud Muhanna Alshammari
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