49-year-old Abu Dhabi patient shows why abdominal pain pathways need faster escalation

Burjeel Hospital Abu Dhabi treated a 49-year-old woman for a rare pancreatic disorder after months of abdominal pain, a case that should push UAE clinics to tighten escalation rules for persistent upper abdominal symptoms.

The case, reported by Gulf Today on 8 October 2026, matters most to clinic COOs, medical directors and insurers. The operating risk is narrow but expensive: abdominal pain that looks routine can require imaging, specialist review and long-term anticoagulation. In Dubai, clinics licensed by the Dubai Health Authority (DHA) need clear referral routes. In Abu Dhabi and Al Ain, the same issue sits under the Department of Health Abu Dhabi (DOH). In Sharjah, Ajman, Ras Al Khaimah, Fujairah and Umm Al Quwain, operators should map escalation to Ministry of Health and Prevention (MOHAP)-licensed providers.

What happened in Abu Dhabi

Dr Niyas Khalid, an internal medicine specialist at Burjeel Hospital Abu Dhabi, told Gulf Today the patient had intermittent abdominal pain and constipation for several months before developing persistent pain for approximately three to four days. The pain became severe, mainly in the upper abdomen, and radiated to the back.

“That was the key question for us. Why are her pancreatic enzymes low when, with the degree of her pancreatic injury, I would expect them to be high?” Dr Niyas Khalid, internal medicine specialist, Burjeel Hospital Abu Dhabi.

The diagnosis was reported as a rare, under-recognised form of venous ischaemic pancreatitis. Imaging showed pancreatic injury and veins filled with acute thrombus. The unusual point was the bloodwork: amylase was 22 U/L and lipase was 18 U/L, with serial readings staying low despite radiological injury.

Khalid said the patient had undergone two previous bariatric procedures. He told Gulf Today bariatric surgery could be a clinically relevant contributor because it may be linked to altered blood flow, dehydration, rapid weight change, abdominal pressure and a pro-thrombotic state. The initial treatment was low-molecular-weight heparin, followed by an oral anticoagulant. The patient resumed daily activity but needs long-term anti-blood clotting treatment, vascular follow-up and regular reassessment.

What clinics and insurers should check

For Dubai clinics, the practical question is when a patient leaves primary care and enters a higher-acuity pathway. DHA’s Sheryan licensing system and Dubai Medical Registry set the licensed facility and professional base. Operators should use those records to keep referral agreements current for imaging, emergency departments, gastroenterology, vascular medicine and internal medicine.

For Abu Dhabi providers, the DOH healthcare facility licensure standard requires facilities to be licensed by DOH and to maintain staff medical liability cover. Daman and Thiqa network eligibility should be checked before non-emergency follow-up, but emergency symptoms should be triaged on clinical risk first.

• COOs should audit abdominal pain pathways for symptoms lasting three days or more, pain radiating to the back, abdominal distension, constipation with distress and post-bariatric surgery history.
• CFOs should require written estimates for consultation, laboratory tests, ultrasound or CT, and specialist referral before scheduled care.
• Medical directors should make low or normal amylase and lipase an escalation flag when symptoms and imaging do not match the blood test result.
• Insurers should review pre-authorisation rules where initial enzymes are low but imaging shows acute injury.

The cost issue is hard to benchmark because UAE private providers price by facility, network contract and clinical code. A safe operating rule is to quote each element separately: physician assessment, amylase and lipase testing, abdominal ultrasound, contrast CT if ordered, anticoagulant initiation and follow-up. Patients should ask for the insurer pre-authorisation number, network status and written out-of-pocket estimate before scheduled imaging. For emergency abdominal pain, the clinical triage record matters because Dubai insurance rules classify emergency condition by symptoms, including severe pain, rather than final diagnosis.

Why it matters beyond one case

The patient’s story is a reminder that UAE clinics sit at the first financial and clinical decision point. A delayed referral can become an inpatient episode. A premature imaging request can trigger a rejected claim.

Dubai operators should review DHA-licensed referral partners first because patient movement across private clinics is common. Abu Dhabi operators should confirm DOH-licensed imaging and specialist capacity for Daman and Thiqa patients. Northern emirates clinics should keep MOHAP-licensed referral options visible for staff, especially where patients may travel to Dubai or Abu Dhabi for complex imaging or specialist care.

Patients and clinic teams can verify licensed providers through the UAE Open Healthcare Directory, which lists more than 12,394 healthcare providers across the seven emirates.