Etiology of Abdominal Pain in Dengue Fever

Abstract

Abdominal pain is a commonly reported symptom in DF. The reported causes of abdominal pain in DF include hepatitis, pancreatitis, acaculous cholecystitis and peptic ulcer disease. Till to date, there has been no planned study to evaluate the cause of pain abdomen in DF. This study was planned to evaluate the etiology of abdominal pain in DF. Patients presenting with fever and pain abdomen to our hospital from July to November 2003 and July to November 2004 were included in the study. A probable diagnosis of DF was made based on the presence of acute febrile illness with two or more of the following manifestations: headache, retroorbital pain, myalgia, arthralgia, rash, haemorrhagic manifestation and leukopenia. The diagnosis was confirmed by enzyme immunoassay-based serology. DHF was diagnosed based on WHO criteria. The cause of pain abdomen was ascertained by blood tests (amylase, lipase and liver function test), radiology (X-ray abdomen-erect and supine, USG, CECT) and/or endoscopy. Out of the 100 patients presenting with fever and pain abdomen, 55 patients were diagnosed to have DF. The remaining 45 patients had other causes of fever with pain abdomen. The various causes of pain abdomen diagnosed in patients with DF were: acute hepatitis, acalculus cholecystitis, acute pancreatitis, appendicitis, spontaneous bacterial peritonitis, enteritis, peptic ulcer disease and gastric erosions in 20 (36.4%), 9 (16.4%), 8 (14.5%), 3 (5.45%), 2 (3.63%), 8 (14.54%), 2 (3.63%) and 3 (5.45%) of the patients respectively. In patients with dengue fever, the etiology of abdominal pain should be aggressively looked into for