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Part of the book series: Updates in Surgery ((UPDATESSURG))

Abstract

Nonspecific abdominal pain (NSAP) is not a defined disease, but is a collection of conditions. The term NSAP refers to an abdominal or pelvic pain of less than 7 days’ duration for which the diagnosis remains uncertain after clinical examination and baseline investigations [1]. Clearly, it must not be accompanied by signs of peritonitis, hemodynamic instability, or other obvious clinical presentation requiring urgent intervention.

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References

  1. de Dombal FT, Leaper DJ, Staniland JR et al (1972) Computer-aided diagnosis of acute abdominal pain. Br Med J 2:9–13

    Article  PubMed  Google Scholar 

  2. Brewer BJ, Golden GT, Hitch DC et al (1976) Abdominal pain. An analysis of 1,000 consecutive cases in a University Hospital emergency room. Am J Surg 131:219–223

    Article  PubMed  CAS  Google Scholar 

  3. Wilson DH, Wilson PD, Walmsley RG et al (1977) Diagnosis of acute abdominal pain in the accident and emergency department. Br J Surg 64:250–254

    Article  PubMed  CAS  Google Scholar 

  4. de Dombal FT (1986) The OMGE acute abdominal pain survey. Progress report. Scand J Gastroenterol 144:35–42

    Google Scholar 

  5. Irvin TT (1989) Abdominal pain: a surgical audit of 1190 emergency admissions. Br J Surg 76:1121–1125

    Article  PubMed  CAS  Google Scholar 

  6. Campbell WB, Lee EJ, Van de Sijpe K et al (2002) A 25-year study of emergency surgical admissions. Ann R Coll Surg Engl 84:273–277

    Article  PubMed  CAS  Google Scholar 

  7. Telfer S, Fenyö G, Holt PR et al (1988) Acute abdominal pain in patients over 50 years of age. Scand J Gastroenterol Suppl 144:47–50

    PubMed  CAS  Google Scholar 

  8. Sheridan WG, White AT, Havard T et al (1992) Non-specific abdominal pain: the resource implications. Ann R Coll Surg Engl 74:181–185

    PubMed  CAS  Google Scholar 

  9. Raheja SK, McDonald PJ, Taylor I (1990) Non-specific abdominal pain-an expensive mystery. J R Soc Med 83:10–11

    PubMed  CAS  Google Scholar 

  10. Adams ID, Chan M, Clifford PC et al (1986) Computer aided diagnosis of acute abdominal pain: a multicentre study. BMJ 293:800–804

    Article  PubMed  CAS  Google Scholar 

  11. Allemann F, Cassina P, Röthlin M et al (1999) Ultrasound scans done by surgeons for patients with acute abdominal pain: a prospective study. Eur J Surg 165:966–970

    Article  PubMed  CAS  Google Scholar 

  12. Rao PM, Rhea JT, Novelline RA et al (1998) Effect of computed tomography of the appendix on treatment of patients and use of hospital resources. N Engl J Med 338:141–146

    Article  PubMed  CAS  Google Scholar 

  13. Champault G, Rizk N, Lauroy J et al (1993) Right iliac fossa pain in women. Conventional diagnostic approach versus primary laparoscopy. A controlled study (65 cases). Ann Chir 47:316–319

    PubMed  CAS  Google Scholar 

  14. Decadt B, Sussman L, Lewis MP et al (1999) Randomized clinical trial of early laparoscopy in the management of acute non-specific abdominal pain. Br J Surg 86:1383–1386

    Article  PubMed  CAS  Google Scholar 

  15. Gaitán H, Angel E, Sánchez J et al (2002) Laparoscopic diagnosis of acute lower abdominal pain in women of reproductive age. Int J Gynaecol Obstet 76:149–158

    Article  PubMed  Google Scholar 

  16. Morino M, Pellegrino L, Castagna E et al (2006) Acute nonspecific abdominal pain: A randomized, controlled trial comparing early laparoscopy versus clinical observation. Ann Surg 244:881–886

    Article  PubMed  Google Scholar 

  17. Schietroma M, Carlei F, Cappelli S et al (2007) Acute abdomen: early laparoscopy or active laparotomic-laparoscopic observation-Hepatogastroenterology 54:1137–1141

    PubMed  CAS  Google Scholar 

  18. Poulin EC, Schlachta CM, Mamazza J (2000) Early laparoscopy to help diagnose acute nonspecific abdominal pain. Lancet 355:861–863

    Article  PubMed  CAS  Google Scholar 

  19. Flum DR, Koepsell T (2002) The clinical and economic correlates of misdiagnosed appendicitis: nationwide analysis. Arch Surg 137:799–804

    Article  PubMed  Google Scholar 

  20. Bau A, Atri M (2000) Acute female pelvic pain: ultrasound evaluation. Semin Ultrasound CT MR 21:78–93

    Article  PubMed  CAS  Google Scholar 

  21. Butala P, Greenstein AJ, Sur MD et al (2010) Surgical management of acute right lower-quadrant pain in pregnancy: a prospective cohort study. J Am Coll Surg 211:490–494

    Article  PubMed  Google Scholar 

  22. Gerhardt RT, Nelson BK, Keenan S et al (2005) Derivation of a clinical guideline for the assessment of nonspecific abdominal pain: the Guideline for Abdominal Pain in the ED Setting (GAPEDS) Phase 1 Study. Am J Emerg Med 23:709–717

    Article  PubMed  Google Scholar 

  23. Strömberg C, Johansson G, Adolfsson A (2007) Acute abdominal pain: diagnostic impact of immediate CT scanning. World J Surg 31:2347–2354

    Article  PubMed  Google Scholar 

  24. Chen MM, Coakley FV, Kaimal A et al (2008) Guidelines for computed tomography and magnetic resonance imaging use during pregnancy and lactation. Obstet Gynecol 112:333–340

    Article  PubMed  Google Scholar 

  25. Sauerland S, Agresta F, Bergamaschi R et al (2006) Laparoscopy for abdominal emergencies: evidence-based guidelines of the European Association for Endoscopic Surgery. Surg Endosc 20:14–29

    Article  PubMed  CAS  Google Scholar 

  26. Sugarbaker PH, Sanders JH, Bloom BS et al (1975) Preoperative laparoscopy in diagnosis of acute abdominal pain. Lancet 1:442–445

    Article  PubMed  CAS  Google Scholar 

  27. Vander Velpen GC, Shimi SM, Cuschieri A (1994) Diagnostic yield and management benefit of laparoscopy: a prospective audit. Gut 35:1617–1621

    Article  Google Scholar 

  28. Cuesta MA, Eijsbouts QA, Gordijn RV et al (1998) Diagnostic laparoscopy in patients with an acute abdomen of uncertain etiology. Surg Endosc 12:915–917

    Article  PubMed  CAS  Google Scholar 

  29. Kirshtein B, Roy-Shapira A, Lantsberg L et al (2003) The use of laparoscopy in abdominal emergencies. Surg Endosc 17:1118–1124

    Article  PubMed  CAS  Google Scholar 

  30. Golash V, Willson PD (2005) Early laparoscopy as a routine procedure in the management of acute abdominal pain: a review of 1,320 patients. Surg Endosc 19:882–885

    Article  PubMed  CAS  Google Scholar 

  31. Agresta F, Mazzarolo G, Ciardo LF et al (2008) The laparoscopic approach in abdominal emergencies: has the attitude changed-: A single-center review of a 15-year experience. Surg Endosc 22:1255–1262

    Article  PubMed  CAS  Google Scholar 

  32. Karamanakos SN, Sdralis E, Panagiotopoulos S et al (2010) Laparoscopy in the emergency setting: a retrospective review of 540 patients with acute abdominal pain. Surg Laparosc Endosc Percutan Tech 20:119–124

    Article  PubMed  Google Scholar 

  33. Maggio AQ, Reece-Smith AM, Tang TY et al (2008) Early laparoscopy versus active observation in acute abdominal pain: systematic review and meta-analysis. Int J Surg 6:400–403

    Article  PubMed  Google Scholar 

  34. Gaitán HG, Reveiz L, Farquhar C (2011) Laparoscopy for the management of acute lower abdominal pain in women of childbearing age. Cochrane Database Syst Rev 1:CD007683

    PubMed  Google Scholar 

  35. Stefanidis D, Richardson WS, Chang L et al (2009) The role of diagnostic laparoscopy for acute abdominal conditions: an evidence-based review. Surg Endosc 23:16–23

    Article  PubMed  Google Scholar 

  36. Domínguez LC, Sanabria A, Vega V et al (2011) Early laparoscopy for the evaluation of nonspecific abdominal pain: a critical appraisal of the evidence. Surg Endosc 25:10–8

    Article  PubMed  Google Scholar 

  37. Onur OE, Guneysel O, Unluer EE et al (2008) “Outpatient follow-up” or “Active clinical observation” in patients with nonspecific abdominal pain in the Emergency Department. A randomized clinical trial. Minerva Chir 63:9–15

    PubMed  CAS  Google Scholar 

Suggested Readings

  • Sauerland S, Agresta F, Bergamaschi R, Borzellino G, Budzynski A, Champault G, Fingerhut A, Isla A, Johansson M, Lundorff P (2006) Laparoscopy for abdominal emergencies. Evidencebased guidelines of the European Association for Endoscopic Surgery. Surg Endosc 20:14–29

    Article  PubMed  CAS  Google Scholar 

  • Agresta F, Ansaloni L, Baiocchi L, Bergamini C, Campanile FB, Carlucci M, Cocorullo G, Corradi A, Franzato B, Lupo M, MandalĂ  V, Mirabella A, Pernazza G, Piccoli M, Staudacher C, Vettoretto N, Zago M, Lettieri E, Levati A, Pietrini D, Scaglione M, De Masi S, De Placido G, Francucci M, Rasi M, Scaramuzza G, Del Favero AL (2011) Consensus Development Conference of the SocietĂ  Italiana Chirurgia Endoscopica e nuove tecnologie (SICE); Associazione Chirurghi Ospedalieri Italiani (ACOI); SocietĂ  Italiana di Chirurgia (SIC); SocietĂ  Italiana Chirurgia d’Urgenza e Trauma (SICUT), SocietĂ  Italiana Chirurghi dell’OspedalitĂ  Privata (SICOP) and the European Association for Endoscopic Surgery (EAES). In press

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Morino, M., Famiglietti, F. (2012). Nonspecific Abdominal Pain. In: MandalĂ , V. (eds) The Role of Laparoscopy in Emergency Abdominal Surgery. Updates in Surgery. Springer, Milano. https://doi.org/10.1007/978-88-470-2327-7_11

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  • DOI: https://doi.org/10.1007/978-88-470-2327-7_11

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-2326-0

  • Online ISBN: 978-88-470-2327-7

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