From the Guidelines
Abdominal pain accounts for approximately 5-10% of all emergency department visits in the United States, with about 7 million visits annually, making it a significant burden on healthcare systems. According to the study by 1, about one-third of patients who present to the emergency department with abdominal pain never have a diagnosis established, one-third have appendicitis, and one-third have some other documented pathology. The most common causes of abdominal pain include acute cholecystitis, small-bowel obstruction, pancreatitis, renal colic, perforated peptic ulcer, cancer, and diverticulitis.
In terms of hospitalization rates, approximately 25% of patients with abdominal pain require hospitalization for further evaluation and treatment, with elderly patients (over 65) having higher hospitalization rates (approximately 50%) compared to younger patients (about 20%) 1. Gender differences are also notable, with women accounting for approximately 60% of all abdominal pain-related visits. The economic impact is substantial, with annual healthcare costs for abdominal pain evaluation and treatment estimated at $10 billion in the United States alone.
Some key statistics related to abdominal pain include:
- 5-10% of all emergency department visits in the United States are due to abdominal pain
- 7 million emergency department visits annually are attributed to abdominal pain
- 25% of patients with abdominal pain require hospitalization for further evaluation and treatment
- 50% of elderly patients (over 65) with abdominal pain are hospitalized, compared to 20% of younger patients
- Women account for approximately 60% of all abdominal pain-related visits
- Annual healthcare costs for abdominal pain evaluation and treatment are estimated at $10 billion in the United States alone.
The study by 1 highlights the importance of imaging in the evaluation of patients with nonspecific abdominal pain, with computed tomography (CT) playing a crucial role in determining management, especially in instances where the positive result is not concordant with the initial diagnostic consideration. The American College of Radiology has developed clinical guidelines, the Appropriateness Criteria, to help physicians choose the most appropriate imaging study based on the location of abdominal pain 1.
From the Research
Hospital/Clinic Visit Statistics
- Abdominal pain is among the most frequent ailments reported in the office setting and can account for up to 40% of ailments in the ambulatory practice 2
- It is in the top three symptoms of patients presenting to emergency departments (ED) and accounts for 5-10% of all ED primary presenting ailments 2
- Acute abdominal pain is considered to be one of the most elusive and common complaints among patients presenting to the emergency department and primary care settings across the U.S. 3
Causes of Abdominal Pain
- The most common causes of acute abdominal pain are gastroenteritis and nonspecific abdominal pain, followed by cholelithiasis, urolithiasis, diverticulitis, and appendicitis 4
- Extra-abdominal causes such as respiratory infections and abdominal wall pain should be considered 4
Evaluation and Diagnosis
- Pain location, history, and examination findings help guide the workup after ensuring hemodynamic stability 4
- Recommended tests may include a complete blood count, C-reactive protein, hepatobiliary markers, electrolytes, creatinine, glucose, urinalysis, lipase, and pregnancy testing 4
- Imaging studies are chosen based on the location of pain and index of suspicion for specific etiologies 4