The differential diagnosis of abdominal pain is extensive and requires a logical evaluation. This article will tell you about the various diagnosis for abdominal pain, arising in. The two most common causes of acute pancreatitis are a gallstone blocking the. This was the largest increase out of 20 common conditions seen in the ed. Differential diagnosis of causes of pain in the lower back accompanied by sciatic pain paul b. The frequency of abdominal pain as a symptom in patients with aids is unknown. Differential diagnosis for abdominal pain abdominal pain is a very common health problem that almost everyone of us have suffered from. Feverweaknesssyncopealtered mental statusseizuredizziness and vertigoheadachesore throatdyspneachest painabdominal painnausea and vomitinggastrointestinal bleedingacute pelvic painback pain pathophysiology of abdominal pain. Pancreatitis is a condition characterized by inflammation of the pancreas. It is in many cases a medical surgical non trauma emergency, requiring urgent and specific diagnosis. Acute abdominal pain gastrointestinal disorders msd. Jul 17, 2018 the evaluation of elderly patients presenting with abdominal pain poses a difficult challenge for the emergency physician.
Differential diagnosis of low back pain article pdf available in seminars in pain medicine 23. Differential diagnosis of acute abdominal pain oscestop. Differential diagnosis of recurrent abdominal pain. Poor sensitivity of the history and physical exam broad differential diagnosis that crosses several specialties often negative diagnostic work up. In addition to considering recurrent appendicitis, the differential diagnosis of the right lower quadrant pain includes crohns disease excluded if your daughter has had a normal small bowel xray, ovarian etiologies ruptured cyst or ovulation discomfort unlikely in view of the duration of pain and serositis related to a possible. There may on occasion be some confusion about whether the patients pain is. Assessment and differential diagnosis of abdominal pain. Differential diagnosis of common cause of acute abdominal pain study guide by nedamoza includes 105 questions covering vocabulary, terms and more. Differential diagnosis of common cause of acute abdominal pain. Cause grouping differentials classical history classic examination findings investigation findings initial test, diagnostic test. Differential diagnosis of causes of pain in the lower back. Abdominal pain is a common presentation in the outpatient setting and is challenging to diagnose. Unusual differential diagnosis of upper abdominal pain. In the majority of patients with aids, abdominal pain is directly related to hiv and its consequences 33, but the more common causes of abdominal pain in the general population also need to be considered.
It will become an increasingly common problem because the elderly population in the united states is growing rapidly. Evaluating the patient with right upper quadrant abdominal pain. Of particular importance are pain location see figure location of abdominal pain and possible causes and characteristics, history of similar symptoms, and associated symptoms. Differential diagnosis of acute abdominal pain micki raber, msn, fnpc, pnpc cindy herf, msn, fnpc slide 2. The evaluation of elderly patients presenting with abdominal pain poses a difficult challenge for the emergency physician. June 1 to 15, 2010, at the emergency department ed of inonu. A history and focused physical examination will lead to a differential diagnosis of abdominal pain, which will then inform. Pdf the differential diagnosis of painful thyroid disorders. Uncommon differential diagnoses and potential complications table 6 uncommon differential diagnosis for abdominal pain medical condition relevant findings and potential complications gastrointestinal intussusception colicky pain, flexing of legs, fever, lethargy, vomiting, peak incidence in children at 6 months of age. Differential diagnosis of shoulder pain followed by. The emergency and nonurgent evaluation of abdominal pain of adults. A differential diagnosis between pheochromocytoma metastasis and multiple paragangliomas was considered. They may have had an injury and had a gradual onset of pain in the.
The pain can arise due to various serious or nonserious causes. The differential diagnosis for pancreatitis includes but is not limited to. Other common diagnoses of abdominal pain in men and women are as follows. Abdominal pain is one of the most frequent complaints in primary care most patients with abdominal pain have minor, nonsurgical causes. Patients often come to our office with shoulder pain. Neurologic basis for abdominal pain pain receptors in the abdomen respond to mechanical and chemical stimuli. Approach to pediatric abdominal pain learn pediatrics. Most patients have a benign andor selflimited etiology, and the initial goal of evaluation is to identify those patients with a serious etiology that may require urgent intervention.
The age of the child determines the differential diagnosis. A 38yearold man was admitted to our hospital with a threemonth history of upper abdominal pain. Differential diagnosis of acute abdomen is often carried out depending on the location of pain in abdominal quadrants and further characteristics of pain. The evaluation of abdominal pain requires an understanding of the possible mechanisms responsible for pain, a broad differential of common causes, and recognition of typical patterns and clinical presentations. A newborn with abdominal pain american academy of pediatrics. He complained of pain consistent with gastritis, loss of appetite, and minor weight loss, but could not remember a particular situation or time when the pain first started. Upper abdominal pain differential diagnosis at a glance. A diagnosis of pediatrie frap is defined by the rome. Af, cvs risk factors hypovolaemia shock soft abdomen pain out of proportion to exam. Functional abdominal pain is a clinical diagnosis and no workup is. However, lingering symptoms can indicate a chronic disease that should be treated.
Most cases of surgical pain will be diagnosed with a thorough history and examination. Right upper quadrant abdominal pain differential diagnosis. A patient presenting with abdominal pain to the general. Differential diagnosis for lateral abdominal pain acute. Pulmonary embolism is the most common serious cause, found in. Discuss and differentiate between the causes of acute and chronic abdominal pain in a 20yearold versus a 50yearold male. Diagnostic approach and management of acute abdominal pain. At the er the patient was left waiting for nearly 12 hours and after examination he was prescribed pain medication and sent home. Of importance in differential diagnosis, by which these conditions can be excluded, is the presence of past history of characteristic attacks of appendicitis, absence of pain in regions into which renal pain usually extends, lack of urinary symptoms and negative urinalysis. We have already discussed the characteristics of intestinal colics and discussed how to differentiate the three major types of abdominal pain. The differential diagnosis of this swelling might pose a serious problem to a less experienced clinician. Evaluation of abdominal pain in the emergency department. Christopher cheung approach to pediatric abdominal. In order to offer appropriate, costeffective, and timely care to patients with right upper quadrant pain, physicians should take a stepwise approach in diagnosis and treatment.
These events combine to give the typical picture of an. Acute abdomen symptoms and differential diagnoses medical. Cardinal presentations this post is part of a series called cardinal presentations, based on rosens emergency medicine 8th edition. Rates of emergency department visits in the united states for abdominal pain increased 18% from 2006 through 2011. Concomitant symptoms such as heartburn, nausea, vomiting. The following table summarizes differential diagnosis for abdominal pain. Surgical causes of upper abdominal pain pdf 59kb racgp. Selected differential diagnosis of abdominal pain pain location possible diagnoses right upper quadrant biliary.
Differential diagnosis when evaluating a patient with acute abdominal pain, the physician should focus on common conditions that cause abdomi. Recurrent abdominal pain in children american family physician. It is through touch that pain is elicited due to diseases of the abdominal wall or. Differential diagnosis accesssurgery mcgrawhill medical. The clinical history and symptoms of each disease process often have characteristics that can help physician formulate a working differential diagnosis. Abdominal pain acute and chronic, differential diagnosis ddx, gastroenterology if you want to be thorough and not forget anything, use both the anatomic framework and the vindicated men framework. Differential diagnosis of pediatric acute abdominal pain. Two important factors modify the differential diagnosis in patients who present with abdominal pain. Feverweaknesssyncopealtered mental statusseizuredizziness and vertigoheadachesore throatdyspneachest painabdominal painnausea and vomitinggastrointestinal bleedingacute pelvic painback pain pathophysiology of abdominal pain visceral. Biliary and hepatic etiologies cause right upper quadrant pain syndromes. Differential diagnosis of abdominal pain sciencedirect. This study provides guidelines for the evaluation of acute abdominal pain in adults, including history and physical examination, diagnostic testing, and special patient populations.
Request pdf evaluating the patient with right upper quadrant abdominal pain. Biliary colic also known as a gallbladder attack, is when pain occurs due to a gallstone temporarily blocking the bile duct. Differential diagnosis for lateral abdominal pain acute common and important causes of lateral abdominal pain acute for doctors and medical students this page is currently being written and will be available soon. Save my name, email, and website in this browser for the next time i comment. Abdominal pain acute and chronic, differential diagnosis ddx, gastroenterology if you want to be thorough and not forget anything, use both the anatomic framework and the.
He was referred to the emergency department in which an abdominal radiograph revealed gaseous distention of the bowel with a paucity of gas in the pelvis. Abdominal pain as a chief complaint can present a significant diagnostic challenge in the primary care setting. Differential of abdominal pain the differential diagnosis of abdominal pain is extensive. Diagnoses range from benign entities eg, irritable bowel syndrome ibs to lifethreatening diseases eg, ruptured abdominal aortic aneurysms aaas. Abdominal pain is the most common cause for hospital admission in the united states. Chronic pain syndrome cps is a common problem that presents a major challenge to healthcare providers because of its complex natural history, unclear etiology, and poor response to therapy. Symptoms include an intense, dull discomfort located in the right upper quadrant, that may radiate to the back particularly the. Pdf the evaluation of electrocardiogram findings in acute. The differential diagnosis in this young man would be other causes of diffuse bronchiectasis. The only abnormality found at the initial consultation was moderate tenderness in the right upper abdomen.
Diagnostic approach and management of acute abdominal pain article pdf available in acta medica indonesiana 444. Male female perforated ulcer nonspecific gastritis diverticulitis appendicitis acute cholecystitis the other factor is age over 70 years. Definition the term acute abdomen refers to a sudden, severe abdominal pain of unclear etiology that is less than 24 hours in duration. Acute abdominal pain in children differential diagnosis. The intensity of the pain may often scare us, but it is not necessarily due to something serious. Stretch is the principal mechanical stimulus involved in visceral nociception, although distention, contraction, traction, compression, and torsion are also perceived 1. Christopher cheung approach to pediatric abdominal pain. Uncommon differential diagnoses and potential complications table 6 uncommon differential diagnosis for abdominal pain medical condition relevant findings and potential complications gastrointestinal intussusception colicky pain, flexing of legs, fever, lethargy, vomiting, peak incidence in children at. Differential diagnosis of shoulder pain followed by progressive weakness. A thorough history usually suggests the diagnosis see table history in patients with acute abdominal pain. Nov 14, 2015 cardinal presentations this post is part of a series called cardinal presentations, based on rosens emergency medicine 8th edition. Chronic abdominal pain diagnosis and management often challenging factors. Abdominal organs produce symptoms based on their location, e. Mar 18, 2020 differential diagnosis of acute abdomen is often carried out depending on the location of pain in abdominal quadrants and further characteristics of pain.
The first pivotal step in diagnosing abdominal pain is to identify the location of the pain. Abdominal pain differential diagnosis based on location. Evaluation of acute abdominal pain in adults american. Explain the value of a cardiovascular history, the value and limitations of ecg, troponin, and other point of care diagnostics relate how to develop a differential diagnosis for a patient presenting with chest pain.
The most common symptoms of pancreatitis are severe upper abdominal or. The differential diagnosis is broad and includes gastrointestinal gi and. Table 2, and the use of some relatively straightforward investigations. Quizlet flashcards, activities and games help you improve your grades. Differential diagnosis of acute abdominal pain with narration.
Differential diagnosis for lateral abdominal pain acute common and important causes of lateral abdominal pain acute for doctors and medical students this page is. A 57yearold male patient presented with right upper quadrant pain associated with icteric sclera and melena was suspiciously diagnosed as having malignant cholangiocarcinmoa ncbi. Abdominal pain in elderly persons differential diagnoses. One factor in the differential diagnosis is that the administration of 16 mg. There are a variety of conditions that may cause acute abdominal pain in a child. Select a symptom or disease and get instant differential diagnosis information. His examination was remarkable for localized abdominal tenderness and distention. While a variety of diagnostic imaging tests can rule in or out a particular diagnosis, the clinician must make several judgment calls before getting to that point. Emergency department admittance of patients with acute abdominal pain. Abdominal pain and hypertensive crisis as initial manifestation of a.
Abdominal pain is the reason about 3% of adults see their family physician. An otherwise well 46yearold woman presented to her general practitioner with intermittent abdominal pain that had been present for several months. Rightsided upper abdominal pain is a common cause of presentation to general practitioners. A previously healthy 3weekold boy presented with 5 hours of marked fussiness, abdominal distention, and poor feeding. A new patient called for an appointment due to the onset of shoulder pain. Abdominal pain is one of the more common problems that may affect more than 90% of the population. Jan 14, 2020 chronic pain syndrome cps is a common problem that presents a major challenge to healthcare providers because of its complex natural history, unclear etiology, and poor response to therapy. We present a systematic approach to differential diagnosis of painful thyroid disorder. Abdominal pain acute and chronic, differential diagnosis. Pleuritic chest pain is characterized by sudden and intense sharp, stabbing, or burning pain in the chest when inhaling and exhaling. May 25, 2018 differential diagnosis for abdominal pain based on history and physical examination in spite of the fact that area of stomach pain or abdominal pain directs the underlying assessment, related signs and indications are prescient of certain reasons for pain in the abdomen and can limit the differential diagnosis. Differential diagnosis of abdominal pain flashcards quizlet.
The differential diagnosis of abdominal pain is extensive making a concise approach sometimes difficult. Liddle, md assistant professor of orthopedics assistant professor of internal medicine vanderbilt university medical center nashville, tn. At the evaluation he reported sudden onset of pain earlier in the week, a high fever, and instruction to go to the er by his physician. This article will tell you about the various diagnosis for abdominal pain, arising in different parts of your abdomen.
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