First reported 25 Feb 2014•Latest report 8 Nov 2024
Definition
What this concern includes
Includes failures of controls specifically dedicated to recognising, assessing or escalating suspected acute abdominal emergencies, including appreciation of the dangers of an acute abdomen, adequate exploration of abdominal pain and recognition of serious abdominal presentations that require urgent clinical action.
Not included
Excludes generic failures to recognise acute illness or clinical deterioration where no acute abdominal presentation is identified.
Excludes non-abdominal chest-pain, respiratory, cardiac or thromboembolic concerns unless abdominal symptoms are a material part of the acute-abdominal emergency assessment.
Excludes failures in treatment, referral or follow-up after an acute abdominal emergency has been reliably recognised and assessed.
Excludes generic training, communication or documentation deficiencies that are not directly tied to recognition or assessment of an acute abdominal emergency.
Reports
4
Distinct published reports
Individual concerns
4
A report can raise multiple concerns
Date range
2014–2024
First to latest report issue date
Stated actions
13
Described in published responses
Reports over time
Reports over time
Reports about this concern issued each year.
* 2026 is projected from reports observed to 7 Sep 2026.
Most frequent recipients
Most frequent recipients
Reports about this concern sent to each recipient.
NHS England1
Royal College of General Practitioners1
Royal College of Paediatrics and Child Health1
Royal College of Radiologists1
Royal College of Surgeons of England1
Royal Sussex County Hospital1
Sandwell and West Birmingham Hospitals NHS Trust1
University Hospitals Sussex NHS Foundation Trust1
NHS trust2
Executive non-departmental public body1
Healthcare site1
Health professional body1
Professional body1
Concerns and responses across reports
Only concerns grouped under this recurring concern are included. Select any concern, action or position to view the source wording.
Inner South London
Concerns raised1
Failure to recognise retrocaecal appendicitis as a presentation of acute appendicitis or generalised abdominal pain
This report raised 5 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.7
Action
Continue supporting educational resources on appendicitis and managing diagnostic uncertainty through the GP Curriculum and continuing professional development.
Stated by Royal College of General PractitionersStated in progressThe respondent said that this action was in progress when they made their response on 8 November 2024.
Action
Signpost members to the Best Practice Pathway Resource for paediatric acute abdominal pain and appendicectomy.
Stated by Royal College of Paediatrics and Child HealthStated plannedThe respondent said that this action was planned when they made their response on 8 November 2024.
Action
Share the report with Specialty Advisory Committee Chairs for consideration in upcoming curriculum reviews.
Stated by Royal College of Surgeons of EnglandStated completedThe respondent said that this action was complete when they made their response on 8 November 2024.
Action
Review CCRISP course content to determine whether it should explicitly refer to retrocaecal appendicitis.
Stated by Royal College of Surgeons of EnglandStated in progressThe respondent said that this action was in progress when they made their response on 8 November 2024.
Action
Launch the updated CCRISP course version incorporating the completed content review.
Stated by Royal College of Surgeons of EnglandStated plannedThe respondent said that this action was planned when they made their response on 8 November 2024.
Action
Redevelop the Clinical Skills in Emergency Surgery course while reviewing whether to explicitly refer to retrocaecal appendicitis.
Stated by Royal College of Surgeons of EnglandStated in progressThe respondent said that this action was in progress when they made their response on 8 November 2024.
Action
Publish an anonymised educational Surgical Safety vignette about the case in the specified surgical journals and disseminate it to a wide surgical audience.
Stated by Royal College of Surgeons of EnglandStated plannedThe respondent said that this action was planned when they made their response on 8 November 2024.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.1
Position
Current surgical curricula adequately cover retrocaecal appendicitis, so no additional curriculum change is considered necessary beyond ongoing review.
Stated by Royal College of Surgeons of EnglandExisting arrangements considered sufficientThe respondent said that existing arrangements were sufficient, so no further action was needed.
Cheshire
Concerns raised1
Failure of diagnostic guidance to require consideration and exclusion of abdominal aortic aneurysm when diagnosing acute pancreatitis
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.3
Action
Review pancreatitis guideline section 1.2 and consider revising wording about raised lipase or amylase levels and alternative conditions.
Stated by National Institute for Health and Care ExcellenceStated plannedThe respondent said that this action was planned when they made their response on 29 April 2024.
Action
Review the coroner’s concerns about clinical guidance for abdominal aortic aneurysm and acute pancreatitis.
Stated by NHS EnglandStated completedThe respondent said that this action was complete when they made their response on 29 April 2024.
Action
Amend the pancreatitis guideline to clarify that raised lipase or amylase levels support diagnosis but may occur in other conditions.
Stated by National Institute for Health and Care ExcellenceStated completedThe respondent said that this action was complete when they made their response on 29 April 2024.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.4
Position
Guidelines cannot cover all differential diagnoses because each guideline has a defined scope relating to specific medical conditions.
Stated by National Institute for Health and Care ExcellenceOutside remitThe respondent said that this matter was outside its role or authority.
Position
Individual clinicians are responsible for treatment decisions, using professional experience, training and clinical judgement alongside NICE guidelines.
Stated by National Institute for Health and Care ExcellenceRedirects responsibilityThe respondent said that another organisation was responsible for deciding or taking action.
Position
Responsibility for relevant clinical guidelines falls outside NHS England’s remit and authority.
Stated by NHS EnglandOutside remitThe respondent said that this matter was outside its role or authority.
Position
Concerns about relevant clinical guidelines should be referred to the organisations responsible for producing them.
Stated by NHS EnglandRedirects responsibilityThe respondent said that another organisation was responsible for deciding or taking action.
Black Country
Concerns raised1
Failure to undertake an urgent CT scan for acute abdominal presentations
This report raised 4 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.3
Action
Update and reissue the acute abdomen guideline with a pathway flowchart, early CT emphasis, and mandatory consultant discussion before surgical referral.
Stated by Sandwell and West Birmingham Hospitals NHS TrustStated completedThe respondent said that this action was complete when they made their response on 3 January 2024.
Action
Embed the updated acute abdomen guidance through staff dissemination, intranet publication, team discussions, induction and teaching, handover reminders, and anonymised case-learning discussions.
Stated by Sandwell and West Birmingham Hospitals NHS TrustStated completedThe respondent said that this action was complete when they made their response on 3 January 2024.
Action
Audit the acute abdomen pathway to assess the effectiveness of the updated guidance and related safety activities.
Stated by Sandwell and West Birmingham Hospitals NHS TrustStated plannedThe respondent said that this action was planned when they made their response on 3 January 2024.
Brighton and Hove
Concerns raised1
Failure to appreciate the dangers of an acute abdomen
This report raised 10 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
No linked response statements
No respondent-stated action or position is linked to these concerns in the published data.
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Includes failures of controls specifically dedicated to recognising, assessing or escalating suspected acute abdominal emergencies, including appreciation of the dangers of an acute abdomen, adequate exploration of abdominal pain and recognition of serious abdominal presentations that require urgent clinical action.
