Pain in the upper abdomen is a common complaint in medical practice. Assessment of abdominal pain in children differential. In cases of nonspecific abdominal pain, it is crucial to have a meaningful discussion about discharge with the patient and document a robust discharge assessment. Differential of abdominal pain the differential diagnosis of abdominal pain is extensive. Because of the spectrum of etiologies that manifest as abdominal pain, the differential remains broad and diagnosis can be challenging. We have already discussed the characteristics of intestinal colics and discussed how to differentiate the three major types of abdominal pain. Differential diagnosis of leftsided abdominal pain. The pain can arise due to various serious or nonserious causes. Assessment and differential diagnosis of abdominal pain. Abdominal pain in elderly persons differential diagnoses. Safe discharge for undifferentiated abdominal pain sinaiem. Abdominal pain diagnosis medhelps abdominal pain diagnosis center for information, symptoms, resources, treatments and tools for abdominal pain diagnosis. Primary epiploic appendagitis vs colonic diverticulitis. Acute abdominal pain the goal of the evaluation of the patient with acute abdominal pain is an early, efficient, and accurate diagnosis.
Patients in whom the abdominal pain is not reproducible on. Patients with pea experienced an improvement of the abdominal pain and tenderness after 3. The emergency and nonurgent evaluation of abdominal pain of adults discussed elsewhere. Pdf differential diagnosis of abdominal pain in women of. Biliary and hepatic etiologies cause right upper quadrant pain syndromes. The underlying etiology of abdominal pain may include distention, contraction, compression. The assessment of abdominal pain involves an understanding of the mechanisms responsible for pain, a wide differential of common causes, and recognition of classic patterns and clinical presentations. Uncommon differential diagnosis of acute rightsided abdominal. Af, cvs risk factors hypovolaemia shock soft abdomen pain out of proportion to exam v g. Evaluation of acute abdominal pain in adults american academy apr 1, 2008. This was the largest increase out of 20 common conditions seen in the ed. For example, right lower quadrant pain strongly suggests appendicitis. The evaluation of abdominal pain requires an understanding of the possible mechanisms responsible for pain, a broad differential of common causes, and recognition of.
Differential diagnosis and treatment of visceral pain in. Abdominal pain differential diagnosis based on location. A differential diagnosis in chronic lower abdominal pain. The point of pain or the location of the abdominal pain will usually help in diagnosis. Differential diagnoses in abdominal pain organized by time course. Obstetrics and gynecological conditions obgync are difficult to be differentiated from appendicitis in young adult females presenting with acute lower abdominal pain. And so there is a different differential diagnosis for pain in. In most cases, a thorough history and physical exam can narrow the broad differential. Abdominal pain is usually associated with fever, vomiting of bile, bloody diarrhea, rigidity, and tenderness in the abdomen. The differential diagnosis of abdominal pain is the first book of a series of monographs to be published by the. Uncommon differential diagnosis of acute rightsided abdominal pain.
Differential diagnosis of acute abdominal pain micki raber, msn, fnpc, pnpc cindy herf, msn, fnpc slide 2. See evaluation of the adult with abdominal pain in the emergency department and evaluation of the adult with abdominal pain. Diagnostic approach to abdominal pain in adults robert m penner, bsc, md, frcpc, msc sumit r majumdar, md, mph introduction abdominal pain can be a challenging complaint for both primary care and specialist physicians because it is frequently a. Differential diagnosis of pain in the upper abdomen thomas p. When evaluating a patient with acute abdominal pain, the most important elements in making an accurate early diagnosis are the history and physical examination. Differential diagnosis of acute abdominal pain with. Differential diagnosis of pain in the upper abdomen.
Its diagnosis is elusive and requires a high level of conjecture given the disease rarity, vague associated abdominal complaints. Differential diagnosis of abdominal pain flashcards quizlet. This article serves to assist the novice family nurse practitioner student in the examination of abdomen in a patient presenting with acute abdominal pain. The differential diagnosis can then be limited to a subset of conditions that cause pain in that particular quadrant of the abdomen. Abdominal pain is one of the most frequent complaints in primary care most patients with abdominal pain have minor, nonsurgical causes.
Chronic abdominal pain associated with malignancy secondary to direct. It is a very common and nonspecific complaint that can be difficult to diagnose, especially for the family nurse practitioner student. Differential diagnosis of abdominal pain in adults part 01. Acute abdominal pain is usually a selflimiting, benign condition, such as in gastroenteritis, constipation, or viral illness. Diagnostic approach to abdominal pain in adults robert m. For patients with primary symptoms of abdominal pain, a thorough evaluation must be performed to determine if symptoms are musculoskeletal in nature or of a nonmusculoskeletal origin that would warrant a referral to a different healthcare provider. The majority of pediatric abdominal complaints are relatively benign e. Christopher cheung approach to pediatric abdominal. Pdf the incidence of acute abdominal pain ranges between 510% of all visits at. Its diagnosis is elusive and requires a high level of conjecture given the disease rarity, vague associated abdominal complaints and frequent lack of consistent physical findings. Approximately 20% of patients evaluated for abdominal pain in the ed require hospitalet admission for.
Right upper quadrant abdominal pain differential diagnosis. This article covers abdominal pain differential diagnosis. While diagnosing an individual with abdominal pain of acute nature, the doctor usually concentrates on regular conditions that bring about stomach pain or abdominal pain and additionally on more severe conditions. She describes the pain as constant, cramping, currently 810 in severity with radiation to the right flank. Timely and correct diagnosis is clinically challenging. Evaluation of abdominal pain in children differential. Full text full text is available as a scanned copy of the original print version. Get a printable copy pdf file of the complete article 1.
May be colicky or persistant and have associated nv and pallor. The procedure of separation between two or more illnesses which have comparable signs or indications is called as differential diagnosis. 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. If your institution subscribes to this resource, and you dont have a myaccess profile, please contact your librarys reference desk for information on how to. Acute abdominal pain is one of the most common complaints in children, and it poses a diagnostic challenge owing to the variety of underlying causes. The patient states that she has had progressively worsening lower abdominal pain for the past three weeks. Find abdominal pain diagnosis information, treatments for abdominal pain diagnosis and abdominal pain diagnosis symptoms. If such causal factors are absent, as is the case for the majority of patients, rap may be classified as a functional disorder, such as functional recurrent abdominal pain frap. Symptoms include an intense, dull discomfort located in the right upper quadrant, that may radiate to the back particularly the. 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. A retrospective data analysis was performed on 542 female patients who were admitted to a tertiary care hospital with a chief complaint of acute. Approach to pediatric abdominal pain learn pediatrics. Get a printable copy pdf file of the complete article 196k, or click on a page image below to browse page by page. Most common cause of chronic abdominal pain accounting for 90% of abd pain in children recurrent attacks of abd pain at least 2x week for 2 months pain is usally periumbilical and varies in intensity and duration.
Because of the spectrum of aetiologies that manifest as abdominal pain, the differential remains broad and diagnosis can be challenging. Pdf diagnostic approach and management of acute abdominal. This article will tell you about the various diagnosis for abdominal pain, arising in different parts of your abdomen. Abdominal pain in pregnant and postpartum women and patients with hiv is discussed elsewhere. Biliary colic also known as a gallbladder attack, is when pain occurs due to a gallstone temporarily blocking the bile duct.
The first pivotal step in diagnosing abdominal pain is to identify the location of the pain. Definition the term acute abdomen refers to a sudden, severe abdominal pain of unclear etiology that is less than 24 hours in duration. Differential diagnosis accesssurgery mcgrawhill medical. Differential diagnosis for abdominal pain or stomach ache. Abdominal pain is occasionally the sole presenting complaint in a patient with lower lobe pneumonia. Rates of emergency department visits in the united states for abdominal pain increased 18% from 2006 through 2011. Acute abdominal pain is a severe, persistent abdominal pain of sudden onset that is likely to require surgical intervention to treat its cause.
The differential diagnosis of abdominal pain is extensive making a concise approach sometimes difficult. Feverweaknesssyncopealtered mental statusseizuredizziness and vertigoheadachesore throatdyspneachest painabdominal painnausea and vomitinggastrointestinal bleedingacute pelvic painback pain pathophysiology of abdominal pain. Cardinal presentations this post is part of a series called cardinal presentations, based on rosens emergency medicine 8th edition. The normal diagnostic tests include the electrolytes assessment, bun and creatinine level in blood, blood counts, renal as well as liver function tests and more.