In total, we identified 351 patients admitted for acute non-traumatic abdominal pain out of 2,615 patients referred for imaging, representing a rate of 13.4%.

In this study, patients under the age of 10 accounted for 33.6%. The mean age was 23 years, ranging from 7 months to 92 years. Females accounted for 54.7% of cases. Schoolchildren and students accounted for 39.9% of cases. All of these findings are summarized in Table 1.

Table 1. Distribution of patients by sociodemographic characteristics.

The clinical findings were dominated by diffuse abdominal pain in 46.4% of cases. (Table 2)

Table 2.Distribution of patients based on clinical information.

Ultrasound was the most commonly requested imaging modality, accounting for 75.8% of cases. The most common radiological diagnosis was adenolymphitis, found in 36.2% of cases.

In this study, the listed conditions correspond to imaging findings.

Most patients were referred by other healthcare facilities, whose criteria for selecting the imaging modality were not reported in this study. (Table 3)

Table 3. Distribution of patients based on imaging data.

Medical care was provided to 64.1% of patients (Table 4) (Figures 1-5).

Table 4.Breakdown of patients by type of care.

Figure 1. A 22-year-old man admitted with right-sided flank pain; an abdominal ultrasound revealed a fluid collection in the liver with a “shifting sand” echogenic pattern suggestive of a liver abscess (yellow arrow).

Figure 2.A 32-year-old woman presented to the clinic with pelvic pain and a one-month delay in her menstrual period, along with a positive urinary hCG test. An endovaginal ultrasound revealed a right-sided uterine sac consistent with an unruptured ectopic pregnancy (yellow arrow) associated with endometrial thickening of 15 mm (yellow star).

Figure 3.A 5-year-old child presented with diffuse abdominal pain; an ultrasound revealed mesenteric lymphadenopathy consistent with adenolymphitis (yellow stars).

Figure 4.A 48-year-old patient admitted for diffuse abdominal pain; ultrasound revealed a gas curtain (A). A subsequent CT scan demonstrated coffee-bean-like hyperdensity suggestive of colonic obstruction due to sigmoid volvulus (B).

Figure 5.A 56-year-old patient referred for pain in the right iliac fossa, in whom an ultrasound revealed a thick-walled, edematous loop consistent with acute appendicitis.

Au total nous avons colligé 351 patients reçu pour douleur abdominale aigue non traumatiques sur 2615 patients orientés vers un examen d’imagerie soit une fréquence de 13.4%. Touré Z. [12], reported a frequency of 4.3% in 2022. This finding underscores the clinical significance of pain in daily practice, particularly due to the wide range of causes it encompasses (gastrointestinal, gynecological, urological, infectious, etc.) and the need for rapid diagnosis to identify potential surgical emergencies.

In this study, patients under the age of 10 accounted for 33.6%. The mean age was 23 years, with a range of 7 months to 92 years. Deme et al. [13] found a predominance of the 20 - 39 age group (35%) with a mean age of 32 years in their 2020 study in Senegal. In the study by Afef et al. [14], 55.9% of patients aged 6 - 12 years were reported, with a mean age of 10 years in Senegal. In the study by Bakri E. I. [7] in Morocco, the 46 - 60 age group was the largest, with a mean age of 48.9 years. Chin J. Y. et al. [15] found a mean age of 58 years in their 2012 study, which evaluated the utility of abdominal computed tomography in the diagnosis, management, prognosis, and discharge information for patients with acute non-traumatic abdominal pain.

This predominance of pediatric patients in this study could be explained by the high frequency of acute abdominal pain in children, often linked to infectious causes (gastroenteritis, parasitic infections), inflammatory conditions such as mesenteric adenolymphitis, or surgical causes.

We found a clear predominance of female patients, accounting for 54.7% of the total. This finding is consistent with those of Touré Z. [12], and Benaboud M. K. [16], who reported 50.80% and 52.5% of cases, respectively. Chin J. Y. et al. [15] reported a prevalence of 69.3% in their 2012 study. Perry H. et al. [17] reported that 51.9% of patients were female in their 2016 study on the relative accuracy of emergency computed tomography in adults with non-traumatic abdominal pain.

In our context, this result could be explained, on the one hand, by the fact that women present with specific causes of abdominal pain related to gynecological conditions—such as ectopic pregnancy, complicated ovarian cysts, and genital infections; and on the other hand, certain sociocultural and behavioral factors may influence women’s earlier use of healthcare facilities.

The clinical findings were dominated by diffuse abdominal pain in 46.4% of cases. This same finding had been reported by Berthé [18], Benaboud M. K. [16], and Touré Z. [12], who noted diffuse abdominal pain in 28.9%, 33.8%, and 39.69% in their studies, respectively. This contrasts with the study by Bakri E. I. [7], who noted a 36% frequency of right lower quadrant pain in his 2023 study in Morocco. Our finding could be explained by the frequency of infectious and inflammatory abdominal conditions, which often present with generalized pain. This highlights the need for a rigorous clinical evaluation and, frequently, the use of additional tests to guide the etiological diagnosis.

In this study, ultrasound was the most frequently requested test, accounting for 75.8% of cases. Similarly, in the study by Touré Z. [12], ultrasound was requested in 84.13% of cases. Amadou et al. [19] demonstrated that 95% of physicians prescribe abdominal ultrasound as the first-line test for non-traumatic abdominal emergencies in their study, which examined physicians’ choices and motivations in prescribing imaging tests for non-traumatic abdominal emergencies in Togo in 2016. In our context, this proportion of ultrasound requests could be explained by its availability, its non-invasive nature, its speed, its diagnostic effectiveness in certains conditions, and above all its low cost compared to other imaging modalities.

In this study, the most common radiological diagnosis was adenolymphitis in 36.2% of cases. This result differs from that of Touré Z. [12], who reported a predominance of renal colic in 20.62% of cases, followed by mesenteric adenolymphitis in 16.79% of cases in his study. In contrast, Kpossou A. R. [6] in Benin in 2024 and Benaboud M. K. [16] in Morocco in 2018 found 16.5% and 15.5% of acute appendicitis cases, respectively, in their studies. In the study by Berthé I. D. [20], intestinal obstruction was recorded in 44% of cases. Laméris W. et al. [21] found acute appendicitis in 28% of patients, followed by acute diverticulitis (12%) and intestinal obstruction in 7% of patients, in their 2009 study on imaging strategies for the detection of urgent conditions in patients presenting with acute abdominal pain. In the study by Chin J. Y. et al. [15], the main diagnoses were intestinal obstruction in 8.3% of patients, followed by gastrointestinal perforation (7.5%) and colitis in 6.7% of patients.

The predominance of adenolymphitis in this study could be explained, on the one hand, by the high proportion of children in our study population and, on the other hand, by the frequency of this condition, which often occurs in the context of a viral or bacterial infection.