---

  Background & Objective : One percent of emergency ward receptions are acute abdomen problems. Gynecological causes include 20%of them. Relation between physiology of women and abdominal pains challenges diagnosis. Clinical diagnosis in these cases have no substitution and studies about accuracy of diagnosis helps to correct future clinical diagnosis .

  Methods : A cross-sectional study conducted over 148 women whom admitted for acute abdomen causes and operation in Urmia Kosar Hospital during 1375-79. Data of history and Para clinical and also pre and post operation diagnosis Collected by related questionnaire and interpreted .

  Results : Ectopic pregnancy (39.9%), ruptured ovarian cyst (23.6%), ovarian cyst torsion(18.2 % ), abdomen masses unrelated to gynecological system (4.1%), were respectively common causes. Two cases were normal. Five appendicitis cases diagnosed after laparatomy. We observed 76% similarity of diagnosis before and after laparatomy, which coordinated with other studies. Ectopic pregnancy with 66 cases of diagnosis before and 53cases confirmation after operation was related to over diagnosis and 22 cases of ovarian cyst ruptures before operation and 36 cases of them after operation were related to under diagnosis .

  Conclusion : Considering the results, common causes of acute abdomen incur most frequent misdiagnoses. So keeping in mind that sometimes common cases appear atypically and on time using of paraclinic measures can help the surgeon to diagnose correctly before laparatomy .

---

Background & objectives: Trauma is one of the most common causes of death in  the age range 1 to 44 and the third cause of death regardless of age. Abdominal trauma is one of the most common types of trauma. This study aimed to investigate the frequency of causes of laparotomy in penetrating and blunt abdominal traumas in 2016.
Methods: This descriptive study was conducted on 120 medical records of patients hospitalized for penetrating and blunt abdominal traumas in Fatemi Hospital, Ardabil, 2016. The inclusion criterion consisted of all patients undergoing laparotomy due to abdominal trauma. In this study, age, gender, education level, type of trauma (blunt or penetrating), results of laparotomy surgery, physical examination and paraclinical findings of patients before operation were collected by a researcher- made checklist.
Results: The results showed that 80% of the patients were male and 35% were in the age range 20-29years. Of patients, 38.3% had penetrating trauma and 61.7% blunt trauma. The most common mechanism of blunt abdominal trauma was car accident (83.8%). Penetrating object was the cause of all penetrating abdominal traumas. Peritoneal stimulation symptoms were observed in 56.5% of penetrating abdominal traumas and 62.2% of blunt abdominal traumas. Hypotension was observed in 21.7% of patients with penetrating abdominal trauma compared with 62.2% in patients with blunt abdominal trauma. The most prevalent damaged organ in patients with blunt trauma was spleen (51.4%). The most prevalent damaged intraabdominal organ was small bowel (17.4%). Negative laparotomy was significantly higher in patients with penetrating trauma than those with blunt trauma (p<0.0001). Moreover, 9.2% of all patients had died and mortality rate was higher in patients with blunt trauma than penetrating trauma (p<0.05) .
Conclusion: The results of this study showed that: 1. Road traffic accident and penetrating object were the most common causes of laparotomy in patients with blunt and penetrating trauma respectively; 2. Spleen and small bowel were the most prevalent damaged organs in blunt and penetrating abdominal trauma respectively and; 3. Young males were at highest risk of abdominal traumas.