J Korean Soc Emerg Med.  2010 Apr;21(2):191-198.

Acute Abdominal Pain in Patients with Hemorrhagic Fever with Renal Syndrome in the Emergency Department

• Shin DH
• Han SK
• Choi PC
• Lee YH
• Sinn DH

Abstract

PURPOSE
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).
METHODS
The electronic medical records were retrospectively investigated during a 3 year period between January 2006 and December 2008.
RESULTS
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.
CONCLUSION
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.

Keyword

Hemorrhagic fever with renal syndrome; Abdominal pain; Acute abdomen; Military personnel

MeSH Terms

Abdomen
Abdomen, Acute
Abdominal Pain
Ascites
Azotemia
Electronic Health Records
Emergencies
Fever
Hemorrhagic Fever with Renal Syndrome
Humans
Hydrazines
Military Personnel
Physical Examination
Pleural Effusion
Proteinuria
Retrospective Studies
Thrombocytopenia
Hydrazines