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J Korean Soc Emerg Med > Volume 21(2); 2010 > Article
Journal of The Korean Society of Emergency Medicine 2010;21(2): 191-198.
Acute Abdominal Pain in Patients with Hemorrhagic Fever with Renal Syndrome in the Emergency Department
Dong Hyuk Shin, Sang Kuk Han, Pil Cho Choi, Young Han Lee, Dong Hyun Sinn
1Department of Emergency Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Korea. pcmd.choi@samsung.com
2Department of Radiology, Yonsei University College of Medicine, Korea.
3Department of Medicine, Armed Forces Capital Hospital, Korea.
Severe abdominal pain and signs of peritoneal irritation in some patients with hemorrhagic fever with renal syndrome (HFRS) can mimic an acute surgical disease of the abdomen. We performed this study to analyze the clinical features and the laboratory and radiographic findings of HFRS patients who had acute abdominal pain upon visiting the emergency department (ED).
The electronic medical records were retrospectively investigated during a 3 year period between January 2006 and December 2008.
Among the 44 patients with HFRS at the ED, 21 patients (47.7%) complained of acute abdominal pain. On physical examination, three patients (14.3%) had rebound tenderness. The most common laboratory findings were thrombocytopenia, azotemia and proteinuria. Ascites, pericholecystic fluid collection, peri-renal fluid collection and pleural effusion were the major findings of abdominal computed tomography.
Acute abdominal pain can be a presenting symptom of HFRS at the ED. In an endemic area, HFRS should be suspected in young patients who have acute abdominal pain, fever (or history of fever), tenderness (and rebound tenderness) of the abdomen, thrombocytopenia and proteinuria. Failure to recognize HFRS might delay the appropriate diagnostic approach and treatment.
Key words: Hemorrhagic fever with renal syndrome, Abdominal pain, Acute abdomen, Military personnel
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