Acute abdominal pain: emergency diagnosis and managing (Part I)

Acute abdominal pain is a medical challenge for emergency physician due to the variety of possible diagnosis, lack of diagnostic and treatment standard in emergency department and the need of a rapid patient management. It is of paramount importance to quickly rule out or diagnose life threatening clinical conditions as acute myocardial infarction or aortic abdominal aneurism rupture. A few more time is allowed to confirm other diseases that lead to major complications if left untreated as acute appendicitis, testicular torsion and acute pyelonefritis. While acute abdominal pain in the elderly reflect often surgical conditions, it has a benign origin in the majority of young patients who can be generally managed as out patient, after a short clinical observation, with a diagnosis at discharge of non specific abdominal pain. The reason for the development of practical clinical pathways for patient with acute abdominal pain is to facilitate physician in differentiating patient who need hospital admission or a short intensive observation from those who can be safely discharged home.