Evaluating the Clinical Presentation of Acute Abdominal Pain in the Emergency Room at a Tertiary Care Hospital in Pakistan: A Cross-Sectional Study

Background: Acute abdominal pain (AAP) is a significant clinical issue globally, contributing to approximately 7-10% of emergency room (ER) visits. Its broad differential diagnoses, including conditions like appendicitis and bowel obstructions, require rapid and accurate diagnosis for effective management. In Pakistan, the healthcare system, especially in tertiary care hospitals, faces challenges such as limited access to advanced diagnostic tools and specialized professionals, which complicates the management of AAP. This study aims to describe the clinical presentation of AAP in a tertiary care hospital in Pakistan, providing data to inform clinical practice and policy development. Methodology: This cross-sectional study was conducted in the ER of Fazaia Ruth Pfau Medical College Hospital (FRPMCH), Pakistan. Ethical approval was obtained from the Fazaia Ruth Pfau Medical College (FRPMC) ethical review board. Data collection spanned from March to June, focusing on patients aged 18 and above presenting with AAP. Exclusion criteria included patients with chronic abdominal pain, recent surgery, pregnancy, and those unable to consent. A total of 144 patients were recruited using consecutive sampling. Data was collected through face-to-face interviews using a standardized questionnaire in english and urdu. The clinical examination was performed by the attending duty medical officer. Data analysis involved descriptive and inferential statistics using IBM Statistical Package for the Social Sciences (SPSS) Statistics version 26.0. Results: The study included 144 participants, with a balanced gender distribution (47.6% male, 51.7% female). The majority were aged 13-25 years (53.1%), with medical students (43.4%) and personnel action form (PAF) employees (20.7%) being the most common occupations. Gradual onset of pain was reported in 57.2% of cases, and pain duration varied, with 37.9% experiencing symptoms for more than five days. The pain was primarily located in the epigastric (30.3%) and umbilical (29.7%) regions. Non-radiating pain was reported by 73.8%, and 69% rated their pain as severe. Significant correlations were found between pain characteristics and demographic factors, such as age and gender, with older patients experiencing longer pain durations and females reporting more localized pain. Conclusion: This study provides valuable insights into the clinical presentation of AAP in a tertiary care hospital in Pakistan, emphasizing the need for effective pain management strategies, comprehensive triage systems, and continuous education for healthcare providers. These measures are essential to improve the diagnosis, treatment, and overall management of AAP in emergency settings, enhancing patient care and outcomes in Pakistan's healthcare system.