Toshihiko Mayumi1, Masahiro Yoshida2, Susumu Tazuma3, Akira Furukawa4, Osamu Nishii5, Kunihiro Shigematsu6, Takeo Azuhata7, Atsuo Itakura8, Seiji Kamei9, Hiroshi Kondo10, Shigenobu Maeda11, Hiroshi Mihara12, Masafumi Mizooka3, Toshihiko Nishidate13, Hideaki Obara14, Norio Sato15, Yuichi Takayama16, Tomoyuki Tsujikawa17, Tomoyuki Fujii18, Tetsuro Miyata19, Izumi Maruyama20, Hiroshi Honda21, Koichi Hirata22. 1. Department of Emergency Medicine, School of Medicine, University of Occupational and Environmental Health, Kita-Kyushu, Japan. mtoshi@med.uoeh-u.ac.jp. 2. Department of Hemodialysis and Surgery, Chemotherapy Research Institute, International University of Health and Welfare, Ichikawa, Japan. 3. Department of General Internal Medicine, Hiroshima University Hospital, Hiroshima, Japan. 4. Department of Radiological Sciences, Faculty of Health Sciences and Graduate School of Human Health Sciences, Tokyo Metropolitan University, Tokyo, Japan. 5. Department of Obstetrics and Gynecology, University Hospital Mizonokuchi, Teikyo University School of Medicine, Kanagawa, Japan. 6. Department of Vascular Surgery, International University of Health and Welfare, Mita Hospital, Tokyo, Japan. 7. Division of Emergency and Critical Care Medicine, Department of Acute Medicine, Nihon University School of Medicine, Tokyo, Japan. 8. Department of Obstetrics & Gynecology, Juntendo University, School of Medicine, Tokyo, Japan. 9. Department of Radiology, The Aichi Prefectural Federation of Agricultural Cooperatives for Health and Welfare Kainan Hospital, Aichi, Japan. 10. Department of Radiology, Teikyo University School of Medicine, Tokyo, Japan. 11. Emergency Department, Fukui Prefectural Hospital, Fukui, Japan. 12. Center for Medical Education, University of Toyama, Toyama, Japan. 13. Department of Surgery, Surgical Oncology and Science, Sapporo Medical University School of Medicine, Sapporo, Japan. 14. Department of Surgery, Keio University School of Medicine, Tokyo, Japan. 15. Department of Primary Care and Emergency Medicine, Kyoto University Hospital, Kyoto, Japan. 16. Department of Surgery, Ogaki Municipal Hospital, Ogaki, Japan. 17. Comprehensive Internal Medicine, Shiga University of Medical Science, Shiga, Japan. 18. Japan Society of Obstetrics and Gynecology, Tokyo, Japan. 19. Japanese Society for Vascular Surgery, Tokyo, Japan. 20. Japan Primary Care Association, Tokyo, Japan. 21. Japan Radiological Society, Tokyo, Japan. 22. Japanese Society for Abdominal Emergency Medicine, Tokyo, Japan.
Abstract
BACKGROUND: Since acute abdomen requires accurate diagnosis and treatment within a particular time limit to prevent mortality, the Japanese Society for Abdominal Emergency Medicine in collaboration with four other medical societies launched the Practice Guidelines for Primary Care of Acute Abdomen that were the first English guidelines in the world for the management of acute abdomen. Here we provide the highlights of these guidelines [all clinical questions (CQs) and recommendations are shown in supplementary information]. METHODS: A systematic and comprehensive evaluation of the evidence for epidemiology, diagnosis, differential diagnosis, and primary treatment for acute abdomen was performed to develop the Practice Guidelines for Primary Care of Acute Abdomen 2015. Because many types of pathophysiological events underlie acute abdomen, these guidelines cover the primary care of adult patients with nontraumatic acute abdomen. RESULTS: A total of 108 questions based on 9 subject areas were used to compile 113 recommendations. The subject areas included definition, epidemiology, history taking, physical examination, laboratory test, imaging studies, differential diagnosis, initial treatment, and education. Japanese medical circumstances were considered for grading the recommendations to assure useful information. The two-step methods for the initial management of acute abdomen were proposed. Early use of transfusion and analgesia, particularly intravenous acetaminophen, were recommended. CONCLUSIONS: The Practice Guidelines for Primary Care of Acute Abdomen 2015 have been prepared as the first evidence-based guidelines for the management of acute abdomen. We hope that these guidelines contribute to clinical practice and improve the primary care and prognosis of patients with acute abdomen.
BACKGROUND: Since acute abdomen requires accurate diagnosis and treatment within a particular time limit to prevent mortality, the Japanese Society for Abdominal Emergency Medicine in collaboration with four other medical societies launched the Practice Guidelines for Primary Care of Acute Abdomen that were the first English guidelines in the world for the management of acute abdomen. Here we provide the highlights of these guidelines [all clinical questions (CQs) and recommendations are shown in supplementary information]. METHODS: A systematic and comprehensive evaluation of the evidence for epidemiology, diagnosis, differential diagnosis, and primary treatment for acute abdomen was performed to develop the Practice Guidelines for Primary Care of Acute Abdomen 2015. Because many types of pathophysiological events underlie acute abdomen, these guidelines cover the primary care of adult patients with nontraumatic acute abdomen. RESULTS: A total of 108 questions based on 9 subject areas were used to compile 113 recommendations. The subject areas included definition, epidemiology, history taking, physical examination, laboratory test, imaging studies, differential diagnosis, initial treatment, and education. Japanese medical circumstances were considered for grading the recommendations to assure useful information. The two-step methods for the initial management of acute abdomen were proposed. Early use of transfusion and analgesia, particularly intravenous acetaminophen, were recommended. CONCLUSIONS: The Practice Guidelines for Primary Care of Acute Abdomen 2015 have been prepared as the first evidence-based guidelines for the management of acute abdomen. We hope that these guidelines contribute to clinical practice and improve the primary care and prognosis of patients with acute abdomen.
Authors: Gordon Guyatt; Andrew D Oxman; Shahnaz Sultan; Jan Brozek; Paul Glasziou; Pablo Alonso-Coello; David Atkins; Regina Kunz; Victor Montori; Roman Jaeschke; David Rind; Philipp Dahm; Elie A Akl; Joerg Meerpohl; Gunn Vist; Elise Berliner; Susan Norris; Yngve Falck-Ytter; Holger J Schünemann Journal: J Clin Epidemiol Date: 2012-04-27 Impact factor: 6.437
Authors: Massimo Brunetti; Ian Shemilt; Silvia Pregno; Luke Vale; Andrew D Oxman; Joanne Lord; Jane Sisk; Francis Ruiz; Suzanne Hill; Gordon H Guyatt; Roman Jaeschke; Mark Helfand; Robin Harbour; Marina Davoli; Laura Amato; Alessandro Liberati; Holger J Schünemann Journal: J Clin Epidemiol Date: 2012-08-03 Impact factor: 6.437