The natural history and clinical findings in undifferentiated abdominal pain

This was a follow-up study of patients diagnosed in and discharged from the emergency department with undifferentiated abdominal pain to establish the natural history of this condition and to define clinical features of patients with undifferentiated abdominal pain.

ED of a county teaching hospital.

Telephone survey of patients at two to three days (first contact) and again at two to three weeks (second contact) after discharge and retrospective chart review.

All patients 18 years or older discharged with the primary diagnosis of undifferentiated abdominal pain from the ED. Excluded were pregnant patients and those presenting with trauma. Patients unavailable for follow-up contact were not included in further data analysis.

Four hundred three patients were discharged from the ED with undifferentiated abdominal pain. Of these, 307 (76.1% were available for follow-up information. The female-to-male ratio was almost 3:1. At first contact, 26.8% of all patients were pain-free and another 30% improved. At second contact, 59.1% had no pain, and an additional 28.6% reported improvement. Ten patients were hospitalized during the follow-up period for continued abdominal pain, and no deaths were attributed to abdominal conditions. The largest subgroup of patients with undifferentiated abdominal pain was female patients less than 30 years old. Epigastric pain was the most common patient complaint, with nausea second. The abdomens of most patients were nontender on examination. Abnormal laboratory and radiologic findings in patients with undifferentiated abdominal pain were few.

Patients with the diagnosis of undifferentiated abdominal pain have a benign short-term course. Almost 88% of patients were pain-free or improved by two to three weeks after their evaluation. No signs or symptoms clearly identified subgroups of patients with undifferentiated abdominal pain.