Spectrum of Diseases in Patients with Non-Traumatic Acute Abdominal Pain Presenting to General Surgery Department in a Rural Tertiary Care Centre in West Bengal

Background Acute non-traumatic abdominal pain is one of the most common presenting symptoms in emergency of a general surgery department. The etiology is varied for a common symptom and so it is very important to come to an early diagnosis for proper management. Objective To identify the spectrum of diseases leading to acute onset non-traumatic abdominal pain, presented in the general surgery department. Design Institution based prospective observational study. Setting Department of General Surgery, B. S. Medical College, Bankura Duration January 2015 to December 2015. Materials and methods All patients more than 12 years of age presented with non-traumatic abdominal pain in the general surgery department from January 2015 to December 2015 were included in this study. The demographics, diagnosis and outcome were noted in a predesigned, pretested proforma and analyzed. Results The study cohort included total 3538 patients out of which 54.35 % were male. Majority (54.74 %) of the patients were in 25-50 years of age group consisting of 26.59 % male and 28.15 % female. Patients who came for treatment were mostly from lower class of socio-economic group (59.97 %) according to SEC by Govt. Of India.56.21 % patients presented with pain for greater than72 hours duration. The most common site affected being lower abdomen (46.72 %), followed by upper abdomen (36-43 %) and periumbilical (12.37 %).4.46 % patients presented with generalized abdominal pain. Pain was sudden in onset in 67.21 % patients (2378/3538) and 54.97 % patients were having 5-7 scale pain at presentation according to Numeric rating scale of pain. Most common cause was found to be acute appendicitis (16.3 %) followed by acute pancreatitis (11.92 %), acute cholecystitis (9.60 %) and renal colic (7.49 %).74.61 % (2640/3538) patients were managed conservatively and surgical intervention was needed in 25.38 % patients. In hospital mortality rate was 1.72 %. Conclusion The most common cause of non traumatic acute abdominal pain in this study was acute appendicitis affecting young and middle aged population, followed by acute pancreatitis and acute cholecystitis.