Approach to Abdominal Pain

Approach to Abdominal Pain 2018-01-30T16:36:57+00:00

Differential diagnosis

  • On call diagnosis
    • Acute abdomen
      • Mesenteric ischaemia
      • Appendicitis
      • Perforated viscus
      • Ruptured abdominal aortic aneurysm
    • Hepatobiliary
      • Gallstones – biliary colic
      • Acute cholecystitis
      • Ascending cholangitis
      • Acute hepatitis
      • Malignancy with capsular stretch
      • Acute pancreatitis
      • Ascites / spontaneous bacterial peritonitis
      • Portal vein thrombosis
      • Splenic infarction
    • Upper GI
      • Peptic ulcer disease
      • Gastritis
      • Gastro-oesophageal reflux disease
    • Lower GI
      • Diverticular disease
      • Inflammatory bowel disease
      • Colonic obstruction
    • Renal
      • Renal colic
      • Pyelonephritis
      • APKD – ruptured cyst
    • Gynaecological
      • Torsion of ovarian cyst
      • Ectopic pregnancy
      • Ruptured ovarian cyst
      • Endometriosis
      • Pelvic inflammatory disease
      • Dysmenorrhoea
    • Metabolic
      • Diabetic ketoacidosis
    • Autoimmune
      • SLE with gut manifestations
      • Polyarteritis nodosa and mesenteric ischaemia
    • Malignancy
      • Gut lymphoma
      • Colonic malignancy causing obstruction
  • PACES diagnosis
    • Porphyria
    • Familial Mediterranean fever

High yield questions

  • SOCRATES
  • Do you have fever?
  • Have you noticed your skin is yellow?
  • Have you noticed your urine is dark or that your stools are pale?
  • Any pain when passing urine?
  • Any blood in urine?
  • Any diarrhoea?
  • Any blood in stools?
  • Any relation to meals?
  • Any NSAID use?
  • Does the pain go to the back?
  • Is the pain made better by leaning forward?
  • Any history of gallstones or alcohol use?
  • Feel like you are going to the toilet a lot or drinking a lot of water?
  • Any rash or joint pain?
  • Any mental illnesses in the past?
  • Any loss of weight / night sweats?
  • Last menstrual period
  • Contraceptive use
  • Vaginal / penile discharge
  • Irritable bowel syndrome:
    • Any bloating?
    • Any relief after passing motion?

Examination

  • Pulse: regular / irregular
  • Abdominal examination
    • Hepatomegaly / tender hepatomegaly
  • Joints
    • Large joint oligoarthritis for inflammatory bowel disease
  • Skin: rashes

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This Sliding Bar can be switched on or off in theme options, and can take any widget you throw at it or even fill it with your custom HTML Code. Its perfect for grabbing the attention of your viewers. Choose between 1, 2, 3 or 4 columns, set the background color, widget divider color, activate transparency, a top border or fully disable it on desktop and mobile.