title: The Practice Guidelines for Primary Care of Acute Abdomen 2015.
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.
authors.affiliation: Department of Emergency Medicine, School of Medicine, University of Occupational and Environmental Health, Kita-Kyushu, Japan. mtoshi@med.uoeh-u.ac.jp.
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Mayumi
authors.affiliation: Department of Hemodialysis and Surgery, Chemotherapy Research Institute, International University of Health and Welfare, Ichikawa, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Yoshida
authors.affiliation: Department of General Internal Medicine, Hiroshima University Hospital, Hiroshima, Japan.
authors.forename: Susumu
authors.initials: S
authors.lastname: Tazuma
authors.affiliation: Department of Radiological Sciences, Faculty of Health Sciences and Graduate School of Human Health Sciences, Tokyo Metropolitan University, Tokyo, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Furukawa
authors.affiliation: Department of Obstetrics and Gynecology, University Hospital Mizonokuchi, Teikyo University School of Medicine, Kanagawa, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Nishii
authors.affiliation: Department of Vascular Surgery, International University of Health and Welfare, Mita Hospital, Tokyo, Japan.
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Shigematsu
authors.affiliation: Division of Emergency and Critical Care Medicine, Department of Acute Medicine, Nihon University School of Medicine, Tokyo, Japan.
authors.forename: Takeo
authors.initials: T
authors.lastname: Azuhata
authors.affiliation: Department of Obstetrics & Gynecology, Juntendo University, School of Medicine, Tokyo, Japan.
authors.forename: Atsuo
authors.initials: A
authors.lastname: Itakura
authors.affiliation: Department of Radiology, The Aichi Prefectural Federation of Agricultural Cooperatives for Health and Welfare Kainan Hospital, Aichi, Japan.
authors.forename: Seiji
authors.initials: S
authors.lastname: Kamei
authors.affiliation: Department of Radiology, Teikyo University School of Medicine, Tokyo, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kondo
authors.affiliation: Emergency Department, Fukui Prefectural Hospital, Fukui, Japan.
authors.forename: Shigenobu
authors.initials: S
authors.lastname: Maeda
authors.affiliation: Center for Medical Education, University of Toyama, Toyama, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Mihara
authors.affiliation: Department of General Internal Medicine, Hiroshima University Hospital, Hiroshima, Japan.
authors.forename: Masafumi
authors.initials: M
authors.lastname: Mizooka
authors.affiliation: Department of Surgery, Surgical Oncology and Science, Sapporo Medical University School of Medicine, Sapporo, Japan.
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Nishidate
authors.affiliation: Department of Surgery, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Obara
authors.affiliation: Department of Primary Care and Emergency Medicine, Kyoto University Hospital, Kyoto, Japan.
authors.forename: Norio
authors.initials: N
authors.lastname: Sato
authors.affiliation: Department of Surgery, Ogaki Municipal Hospital, Ogaki, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Takayama
authors.affiliation: Comprehensive Internal Medicine, Shiga University of Medical Science, Shiga, Japan.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Tsujikawa
authors.affiliation: Japan Society of Obstetrics and Gynecology, Tokyo, Japan.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Fujii
authors.affiliation: Japanese Society for Vascular Surgery, Tokyo, Japan.
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Miyata
authors.affiliation: Japan Primary Care Association, Tokyo, Japan.
authors.forename: Izumi
authors.initials: I
authors.lastname: Maruyama
authors.affiliation: Japan Radiological Society, Tokyo, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Honda
authors.affiliation: Japanese Society for Abdominal Emergency Medicine, Tokyo, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Hirata
mesh_terms: D000006:Abdomen, Acute / Q000175:diagnosis* / Q000628:therapy*; D000328:Adult; D003952:Diagnostic Imaging; D006801:Humans; D007564:Japan; D011320:Primary Health Care; D012955:Societies, Medical
keywords: Acute abdomen; Analgesia; Diagnosis; Differential diagnosis; Guidelines; Two-step method