Acute surgical conditions presenting to the emergency department, diagnosis, management, and outcomes

Acute surgical conditions are a leading cause of emergency department admissions and contribute to morbidity and mortality. Common conditions include acute appendicitis, diverticular disease, and mesenteric ischemia, which present diagnostic and management challenges due to their varied clinical features. Early recognition and intervention are essential to prevent complications and death. This systematic review was conducted according to PRISMA guidelines. Literature searches in PubMed, Scopus, and Web of Science identified randomized controlled trials, post-hoc analyses, and observational studies evaluating diagnostic and management strategies for acute surgical conditions. Ten eligible studies were included, and data were extracted on diagnostic accuracy, management strategies, complications, mortality, hospital stay, and patient satisfaction. Evidence showed that routine CT scanning increased hospital stay and costs without improving outcomes, whereas bedside ultrasound improved short-term satisfaction. Early laparoscopy reduced undiagnosed cases, morbidity, and hospital stay. Graded nursing and non-physician emergency clinicians improved short-term outcomes in resource-limited settings. Nebulized fentanyl provided safe and effective analgesia. Perioperative hyperoxia increased long-term cardiovascular risk, while biologic mesh prophylaxis was associated with more complications. Effective management of acute surgical conditions requires early diagnosis, individualized treatment, and context-specific strategies. Multidisciplinary collaboration and evidence-based perioperative approaches improve survival, reduce complications, and optimize resources.