Differential diagnosis of common cause of acute abdominal pain study guide by nedamoza includes 105 questions covering vocabulary, terms and more. Differential diagnosis of abdominal pain flashcards quizlet. Abdominal pain and hypertensive crisis as initial manifestation of a. His examination was remarkable for localized abdominal tenderness and distention.
Pdf the differential diagnosis of painful thyroid disorders. Abdominal pain is the reason about 3% of adults see their family physician. 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. There are a variety of conditions that may cause acute abdominal pain in a child. Rightsided upper abdominal pain is a common cause of presentation to general practitioners. One factor in the differential diagnosis is that the administration of 16 mg. Male female perforated ulcer nonspecific gastritis diverticulitis appendicitis acute cholecystitis the other factor is age over 70 years.
Upper abdominal pain differential diagnosis productive medic. Chronic abdominal pain diagnosis and management often challenging factors. Biliary colic also known as a gallbladder attack, is when pain occurs due to a gallstone temporarily blocking the bile duct. 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. The only abnormality found at the initial consultation was moderate tenderness in the right upper abdomen. Electrocardiogram and blood pressure studies will generally establish the differential diagnosis. Abdominal pain differential diagnosis based on location. Abdominal pain is one of the most frequent complaints in primary care most patients with abdominal pain have minor, nonsurgical causes. The evaluation of elderly patients presenting with abdominal pain poses a difficult challenge for the emergency physician. Save my name, email, and website in this browser for the next time i comment. The intensity of the pain may often scare us, but it is not necessarily due to something serious. Differential diagnosis of abdominal pain sciencedirect. A diagnosis of pediatrie frap is defined by the rome. Approach to pediatric abdominal pain learn pediatrics.
Cause grouping differentials classical history classic examination findings investigation findings initial test, diagnostic test. Visceral receptors responsible for these sensations. The differential diagnosis for pancreatitis includes but is not limited to. Christopher cheung approach to pediatric abdominal pain. 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. Differential diagnosis of intraabdominal pain sciencedirect. Evaluation of acute abdominal pain in adults american. Poor sensitivity of the history and physical exam broad differential diagnosis that crosses several specialties often negative diagnostic work up. Differential diagnosis of acute abdominal pain micki raber, msn, fnpc, pnpc cindy herf, msn, fnpc slide 2. A history and focused physical examination will lead to a differential diagnosis of abdominal pain, which will then inform. The following table summarizes differential diagnosis for abdominal pain.
It is in many cases a medical surgical non trauma emergency, requiring urgent and specific diagnosis. The first pivotal step in diagnosing abdominal pain is to identify the location of the pain. Differential diagnosis of acute abdominal pain oscestop. 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. Two important factors modify the differential diagnosis in patients who present with abdominal pain. Abdominal pain is the most common cause for hospital admission in the united states. 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 organs produce symptoms based on their location, e. Diagnostic approach and management of acute abdominal pain article pdf available in acta medica indonesiana 444. This article will tell you about the various diagnosis for abdominal pain, arising in. 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. Abdominal pain in elderly persons differential diagnoses. Diagnoses range from benign entities eg, irritable bowel syndrome ibs to lifethreatening diseases eg, ruptured abdominal aortic aneurysms aaas. The differential diagnosis is broad and includes gastrointestinal gi and. Pleuritic chest pain is characterized by sudden and intense sharp, stabbing, or burning pain in the chest when inhaling and exhaling. Differential diagnosis accesssurgery mcgrawhill medical.
Pulmonary embolism is the most common serious cause, found in. Jul 17, 2018 the evaluation of elderly patients presenting with abdominal pain poses a difficult challenge for the emergency physician. The differential diagnosis of this swelling might pose a serious problem to a less experienced clinician. Stretch is the principal mechanical stimulus involved in visceral nociception, although distention, contraction, traction, compression, and torsion are also perceived 1. Rates of emergency department visits in the united states for abdominal pain increased 18% from 2006 through 2011. Functional abdominal pain is a clinical diagnosis and no workup is. A newborn with abdominal pain american academy of pediatrics.
Differential diagnosis for abdominal pain abdominal pain is a very common health problem that almost everyone of us have suffered from. Christopher cheung approach to pediatric abdominal. However, lingering symptoms can indicate a chronic disease that should be treated. Cardinal presentations this post is part of a series called cardinal presentations, based on rosens emergency medicine 8th edition. Assessment and differential diagnosis of abdominal pain. 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 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.
Patients often come to our office with shoulder pain. The differential diagnosis in this young man would be other causes of diffuse bronchiectasis. Liddle, md assistant professor of orthopedics assistant professor of internal medicine vanderbilt university medical center nashville, tn. Differential diagnosis of low back pain article pdf available in seminars in pain medicine 23. Concomitant symptoms such as heartburn, nausea, vomiting. Feverweaknesssyncopealtered mental statusseizuredizziness and vertigoheadachesore throatdyspneachest painabdominal painnausea and vomitinggastrointestinal bleedingacute pelvic painback pain pathophysiology of abdominal pain. Differential diagnosis of causes of pain in the lower back accompanied by sciatic pain paul b.
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. The two most common causes of acute pancreatitis are a gallstone blocking the. The emergency and nonurgent evaluation of abdominal pain of adults. Differential of abdominal pain the differential diagnosis of abdominal pain is extensive.
This was the largest increase out of 20 common conditions seen in the ed. Select a symptom or disease and get instant differential diagnosis information. Acute abdominal pain gastrointestinal disorders msd. It will become an increasingly common problem because the elderly population in the united states is growing rapidly.
Differential diagnosis for lateral abdominal pain acute. Evaluation of abdominal pain in the emergency department. Differential diagnosis of causes of pain in the lower back. There may on occasion be some confusion about whether the patients pain is. The clinical history and symptoms of each disease process often have characteristics that can help physician formulate a working differential diagnosis. Differential diagnosis of shoulder pain followed by. Abdominal pain as a chief complaint can present a significant diagnostic challenge in the primary care setting. A new patient called for an appointment due to the onset of shoulder pain.
We present a systematic approach to differential diagnosis of painful thyroid disorder. Differential diagnosis of recurrent abdominal pain. 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 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. Upper abdominal pain differential diagnosis at a glance. Acute abdominal pain in children differential diagnosis. Right upper quadrant abdominal pain differential diagnosis. Differential diagnosis of shoulder pain followed by progressive weakness. Emergency department admittance of patients with acute abdominal pain.
Abdominal pain is one of the more common problems that may affect more than 90% of the population. Of particular importance are pain location see figure location of abdominal pain and possible causes and characteristics, history of similar symptoms, and associated symptoms. 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. The pain can arise due to various serious or nonserious causes. Pdf the aim of this study was to determine the diagnostic value of electrocardiogram in differential diagnosis of patients with nonspecific abdominal. We have already discussed the characteristics of intestinal colics and discussed how to differentiate the three major types of abdominal pain. A 38yearold man was admitted to our hospital with a threemonth history of upper abdominal pain. Abdominal pain acute and chronic, differential diagnosis. This study provides guidelines for the evaluation of acute abdominal pain in adults, including history and physical examination, diagnostic testing, and special patient populations.
Acute abdomen symptoms and differential diagnoses medical. Other common diagnoses of abdominal pain in men and women are as follows. An otherwise well 46yearold woman presented to her general practitioner with intermittent abdominal pain that had been present for several months. The age of the child determines the 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. 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. Pancreatitis is a condition characterized by inflammation of the pancreas.
Evaluating the patient with right upper quadrant 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. 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. Neurologic basis for abdominal pain pain receptors in the abdomen respond to mechanical and chemical stimuli. Diagnostic approach and management of acute abdominal pain. This article will tell you about the various diagnosis for abdominal pain, arising in different parts of your abdomen. 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 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. 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. Discuss and differentiate between the causes of acute and chronic abdominal pain in a 20yearold versus a 50yearold male. These events combine to give the typical picture of an. Provide a rationale for including the appropriate differential diagnoses in each age group differential diagnosis the causes of acute abdominal pain in older patients are not greatly dissimilar from the causes in younger patients.
Differential diagnosis of common cause of acute abdominal pain. A differential diagnosis between pheochromocytoma metastasis and multiple paragangliomas was considered. 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 of acute abdominal pain with narration. Surgical causes of upper abdominal pain pdf 59kb racgp. Biliary and hepatic etiologies cause right upper quadrant pain syndromes.
Af, cvs risk factors hypovolaemia shock soft abdomen pain out of proportion to exam. The differential diagnosis of abdominal pain is extensive and requires a logical evaluation. Table 2, and the use of some relatively straightforward investigations. 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. Recurrent abdominal pain in children american family physician. 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.
Unusual differential diagnosis of upper abdominal pain. It is through touch that pain is elicited due to diseases of the abdominal wall or. Nov 14, 2015 cardinal presentations this post is part of a series called cardinal presentations, based on rosens emergency medicine 8th edition. A thorough history usually suggests the diagnosis see table history in patients with acute abdominal pain. Differential diagnosis of pediatric acute abdominal pain. Quizlet flashcards, activities and games help you improve your grades. 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. Differential diagnosis for lateral abdominal pain acute common and important causes of lateral abdominal pain acute for doctors and medical students this page is. The frequency of abdominal pain as a symptom in patients with aids is unknown. Request pdf evaluating the patient with right upper quadrant abdominal pain. Differential diagnosis when evaluating a patient with acute abdominal pain, the physician should focus on common conditions that cause abdomi. A previously healthy 3weekold boy presented with 5 hours of marked fussiness, abdominal distention, and poor feeding. The differential diagnosis of abdominal pain is extensive making a concise approach sometimes difficult. Abdominal pain is a common presentation in the outpatient setting and is challenging to diagnose.
Symptoms include an intense, dull discomfort located in the right upper quadrant, that may radiate to the back particularly the. A patient presenting with abdominal pain to the general. Pdf the evaluation of electrocardiogram findings in acute. Most cases of surgical pain will be diagnosed with a thorough history and examination. 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.
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