VALUE OF OBSERVATION AND REVIEW

VALUE OF OBSERVATION AND REVIEW

In the case of acute abdominal pain, there will be a subset of patients in whom, after full clinical assessment, the surgeon remains uncertain about the need for an urgent operation. This is probably the most di ffi cult group to deal with compared with those in whom an urgent operation is either clearly required or clearly not required, and undoubtedly the one in which the majority of errors occur. These include rare causes of abdominal pain and vomiting such as metabolic diseases parathyroidism etc.), referred pain from the spine, heart and lungs and functional pain. Further urgent investigations are obviously needed in this group and these are discussed in some detail elsewhere in this book. However, while these are taking place, regular review of the patient is essential, preferably by the same clinician who initially examined the patient so as not to miss any subtle changes or worsening of the situation. Such a period of observation is an integral part of the early management of patients with acute abdominal pain.