A Prospective Observational Study on the Diagnosis and Management of Non-Traumatic Abdominal Emergencies in a...

Non-traumatic abdominal emergencies (NTAEs) represent a diverse group of acute abdominal conditions that arise spontaneously and require prompt evaluation and management. These include common presentations such as acute appendicitis, ureteric colic, and pancreatitis. With the rising prevalence of non-communicable diseases like diabetes and hypertension, the clinical profile and complexity of these emergencies are increasing.

To analyze the clinical spectrum, diagnostic patterns, management strategies, and outcomes of non-traumatic abdominal emergencies in a tertiary care setting.

This prospective observational study was conducted over 18 months in a tertiary care hospital and included 103 adult patients diagnosed with NTAEs. Data on demographics, comorbidities, diagnosis, time of presentation, mode of treatment, and hospital stay were analyzed. Statistical significance was set at p < 0.05.

Among the 103 patients, 64 (62.1%) were males and 39 (37.9%) females. A total of 88 patients (85.4%) presented within 72 hours of symptom onset. The most common diagnoses were ureteric colic (n = 20, 19.4%), acute appendicitis (n = 15, 14.6%), and acute pancreatitis (n = 10, 9.7%). Conservative management was sufficient in 76 patients (73.8%), while 27 patients (26.2%) underwent surgical intervention. Comorbidities included diabetes mellitus in 31 patients (30.1%), hypertension in 29 (28.2%), and obesity in 33 (32.0%). Surgical intervention was significantly associated with male gender (p = 0.03) and older age (p = 0.01). Surgical patients had a longer mean hospital stay (6.07 ± 1.4 days) compared to non-surgical patients (5.8 ± 1.2 days), which was statistically significant (p = 0.004, t = 2.96). Imaging modalities such as ultrasonography and contrast-enhanced computed tomography (CECT) demonstrated high diagnostic accuracy and influenced treatment decisions in over 90% of cases.

Early recognition and timely imaging are pivotal in the management of NTAEs. Individualized treatment based on imaging and clinical findings is essential. Conservative management remains appropriate for most cases; however, prompt surgical referral should be considered for patients who are older, male, or have severe pathology, as these are significantly associated with the need for surgical intervention. Strengthening diagnostic pathways and enhancing early triage protocols may further improve outcomes in tertiary care settings.