Does usage of peritonism tests in an emergency department have any benefit?
OBJECTIVE
To evaluate the usage of inspiration, expiration, cough, and heel drop jarring tests that are applied for determination of peritonism in cases with acute abdominal pain.


METHODS
A prospective study based on observation of patients between 16-65 years of age and presented to the Emergency Department within a 3-month period starting from June 2007, was conducted. The patients were asked to rate their pain level between "0" and "10". Following the measurement of the vital signs, 4 tests were conducted by an emergency medicine resident. The medical records of all the patients were reviewed after 3 months. Data concerning clinical diagnosis, hospital admission and discharge processes, and surgical results, were all recorded.


RESULTS
Seventy-seven patients had peritonism tests performed. Inspiration test was positive in 29 (of 51, 56.9%) patients admitted to the hospital. However, there was no correlation between the cases admitted to the hospital and the other 3 tests (p more than 0.05). Twenty-one (of 34, 61.8%) patients which have been subjected to surgical treatment, showed positive inspiration test results. Surgical treatment was performed on nine (of 11, 81.8%) patients who showed positive results for all 4 tests.


CONCLUSIONS
The applied tests are helpful in determining a serious abdominal disease, particularly alongside findings of rebound, tenderness, and laboratory results.
1Department of Emergency Medicine, Canakkale Onsekiz Mart University Medical School, Canakkale, 2Erciyes University Medical School, Departments of Emergency Medicine, Kayseri, Turkey, 3Department of Emergency Medicine,Istanbul University Cerrahpasa Medical School; Istanbul, Turkey.
Okhan
O
Akdur
Polat
P
Durukan
Seda
S
Ozkan
Erdogan
E
M Sozuer
Levent
L
Avsarogullari
Ibrahim
I
Ikizceli
D015746:Abdominal Pain / Q000175:diagnosis* / Q000209:etiology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010532:Peritoneal Diseases / Q000150:complications* / Q000175:diagnosis*; D010808:Physical Examination; D011446:Prospective Studies; D055815:Young Adult