Acute abdominal pain and dengue fever.

Objective: To find out the various causes of acute abdomen in patients suffering from acute dengue illness and its correlation to the disease severity. Material and method: In this study, confirmed dengue patients with severe acute abdominal pain admitted to Mayo Hospital and Services Hospital, Lahore, were included for analysis. The severity of DF was categorized in accordance with the World Health Organization definition. Informed consent was taken from all patients. In each patient, details such as symptoms, signs were recorded. Investigations including full blood counts, aspartate aminotransferase (AST), alanine aminotransferase (ALT), serum amylase, serum lipase, prothrombin time (PT), blood urea, serum creatinine level, blood culture, ascitic fluid analysis and culture, ECG, chest radiograph and ultrasound and CT scan of the abdomen were done to help establish diagnosis. Results: Out of 350 patients admitted in the wards as dengue fever, 112(32%) suffered from acute abdominal pain. Patients presented in ages from 17 to 69 years (mean 30.5) 98 (86.7%) were males and 14(12.4%) were females. About 66(58.4%) presented with DF, 39 (34.5%) with DHF and 7(6.2%) with DSS. Commonest presentation was due to hepatic involvement in 64(57.1%). Other causes for acute abdominal pain in the study group were acalculous cholecystitis(10.7%), peptic ulcer disease(9.8%), ascites(5.4%), pancreatitis (5.4%), appendicitis (5.4%) and calculous cholecystitis (3.6%), no cause could be found in 2.7%. Conclusion: A significant proportion of patients suffering from dengue infection suffer from acute abdominal pain. Hence it is important to look for the cause for abdominal pain in dengue infection so that it can be appropriately and timely managed prior to onset of complications.