Magnitude and Pattern of Misdiagnosis in Acute Abdomen Cases Seen in St. Paul’s Hospital Millennium Medical College’s Surgical Emergency Department

Abstract

SUMMARY INTRODUCTION: Acute abdomen refers to the sudden onset of abdominal pain due to abdominopelvic disease entities that require an immediate surgical intervention in most of the cases. Morbidity and mortality outcomes of patients depends on multiple factors. Among those, a reasonable, timely and accurate clinical diagnosis plays a pivotal role in determining subsequent outcomes. Even though, the magnitude of misdiagnosis in a general medical condition is difficult to reliably study due to the challenge of operationalizing the term “misdiagnosis”, it has been well studied in acute abdomen cases especially acute appendicitis. OBJECTIVE: The main objective of the study is to determine the magnitude of misdiagnosis in acute abdomen Cases Seen in St. Paul’s Hospital Millennium Medical College’s Surgical Emergency Department METHOD: With descriptive retrospective cross-sectional study design, 121 samples were selected from the study population via simple random sampling technique. The desired information about each variables of interest was extracted from the patient’s chart documentations and filled into a prepared template. The data was then fed into SPSS version 20. Finally, a descriptive analysis of the data was done to present the sociodemographic variables, pertinent clinical scenarios, magnitude and patterns of misdiagnosis in the operated acute abdomen Cases Seen in SPHMMC’s Surgical Emergency Department. Tables, figures, bar and pie charts are used to present the data. RESULTS: 1 in less than 2 laparotomies done in SPHMMC is for the purpose of appendectomy. The magnitude of misdiagnosis in the operated acute abdomen Cases Seen in SPHMMC’s Surgical Emergency Department was 6.61%. The sample’s male: female ratio was 1.6:1. In contrast, most misdiagnosed cases were females (87.5%). The rate of negative appendectomy was 4.9%, which is within the acceptable range according to standard surgical textbooks. CONCLUSION: Acute abdomen is the most common cause of acute abdomen. The magnitude of misdiagnosis in acute abdomen cases is comparable with other studies. Females are more likely to get misdiagnosed than males.