title: [Classification and management of gynecologic acute abdomen at a secondary level hospital emergency department].
abstract: This study retrospectively evaluates the preoperative work-up and the classification and operative treatment of acute abdomen caused by gynaecological disorders in emergency admissions to our department. All female patients admitted in the emergency setting and operated on for gynaecological acute abdomen in our emergency department over the period from 1997 to 2002 were included in the study. A total of 103 patients were identified (54 undergoing emergency operations, 9 operated on within 72 hours, and 40 managed conservatively with medical therapy. The 54 emergency operations performed were 24 ovarian resections, 17 salpingectomies, 5 oophorectomies, 4 exploratory laparotomies, 2 uterine polypectomies and 2 hysterectomies. The non-specific presentation of the disease and an inadequate preoperative work-up in these patients often led to a generic diagnosis at admission. This approach tends to increase the number of operations performed on an emergency basis, whereas a wait-and-see type of management should be adopted. A proper use of surgery is mandatory especially in those patients in whom preservation of reproductive capability has a major impact on outcome.
authors.affiliation: Servizio Speciale Chirurgia D'Urgenza 1-2, Dipartimento di Chirurgia Pietro Valdoni, Policlinico Umberto I, Roma, Università degli Studi di Roma La Sapienza.
authors.forename: Marco
authors.initials: M
authors.lastname: Assenza
authors.forename: Francesco
authors.initials: F
authors.lastname: Romagnoli
authors.forename: Piero
authors.initials: P
authors.lastname: Bartolucci
authors.forename: Barbara
authors.initials: B
authors.lastname: Tomei
authors.forename: Gabriele
authors.initials: G
authors.lastname: Ricci
authors.forename: Claudio
authors.initials: C
authors.lastname: Modini
mesh_terms: D000006:Abdomen, Acute / Q000145:classification* / Q000601:surgery*; D000328:Adult; D004636:Emergency Service, Hospital; D004638:Emergency Treatment; D005260:Female; D005831:Genital Diseases, Female / Q000145:classification* / Q000601:surgery*; D006801:Humans; D012189:Retrospective Studies