Designed to test clinical reasoning skills, this video provides opportunities to answer questions, practice history taking, and develop an assessment and differential diagnosis as well as an. Abdominal pain acute differential diagnosis free questions and answers for doctors and medical student exams. Differential diagnosis of abdominal pain flashcards quizlet. Differential diagnosis of shoulder pain followed by progressive weakness. The first pivotal step in diagnosing abdominal pain is to identify the location of the pain. To understand it better, there are three major arteries which supply blood to the digestive tract which are the celiac artery, superior mesenteric artery, and the inferior mesenteric artery. Differential diagnosis for central abdominal pain acute common and important causes of central abdominal pain acute for doctors and medical students this page is currently being written and will be available soon. A differential diagnosis in chronic lower abdominal pain. An otherwise well 46yearold woman presented to her general practitioner with intermittent abdominal pain that had been present for several months. Postprandial abdominal paincauses symptomstreatment.
Christopher cheung approach to pediatric abdominal. Differential diagnosis of leftsided abdominal pain. Pdf a differential diagnosis in chronic lower abdominal pain. This article will tell you about the various diagnosis for abdominal pain, arising in different parts of your abdomen. Abdominal pain as a chief complaint can present a significant diagnostic challenge in the primary care setting. Lower abdominal pain is caused by diseases in the colon, bladder, lower ureters and uterus. The most common nonsurgical condition is gastroenteritis, while the most common surgical condition is 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 typical patterns and clinical presentations. Anatomic basis of pain, 71 extraabdominal causes of acute abdomi approach to the patient with stimulants of pain, 72 nal pain, 78 chronic abdominal pain, 80 types of pain, 72 special circumstances, 78 clinical evaluation, 80 approach to the patient with pharmacologic management of the acute diagnosable causes, 81. Back pain colicky pain peritoneal pain vomiting every pain presenting with new onset back pain 60 yrs. Pathologic states associated with priapism give rise to the differential diagnosis.
Evaluation of acute abdominal pain in adults american. Abdominal pain is usually associated with fever, vomiting of bile, bloody diarrhea, rigidity, and tenderness in the abdomen. Differential diagnosis of abdominal pain in adults mary b fishman, md mark d aronson, md. 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. Start studying differential diagnosis of abdominal pain. Acute abdominal pain in children differential diagnosis. This is a very rare occurrence but should be considered in the differential diagnosis of individuals with intrathecal infusion. Assessment of abdominal pain in children differential. Osce 2 presents a clinical encounter of a 64yearold stockbroker who presents with pain in the upper part of the abdomen, which has spread to the back. Very acute abdominal condition is a potential catastrophe.
The differential diagnosis can then be limited to a subset of conditions that cause pain in that particular quadrant of the abdomen figure 31. Primary epiploic appendagitis vs colonic diverticulitis. The following table summarizes differential diagnosis for abdominal pain. Feverweaknesssyncopealtered mental statusseizuredizziness and vertigoheadachesore throatdyspneachest painabdominal painnausea and vomitinggastrointestinal bleedingacute pelvic painback pain. A differential diagnosis in chronic lower abdominal pain ncbi. A differential diagnosis manual is a comprehensive guide on the management of patients suffering from pelvic pain as well as dysfunction of the bowel and bladder systems. Acute abdominal pain in children american family physician. 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. Documentsappcriteriadiagnosticrightupperquadrantpain.
Marcos duarte siosaki, marcia maria hagge coelho costa. In most cases, a thorough history and physical examination can narrow the broad differential. Because of the spectrum of aetiologies that manifest as abdominal pain, the differential remains broad and diagnosis can be challenging. Join a live hosted trivia game for your favorite pub trivia experience done virtually. Assessment and differential diagnosis of abdominal pain. I suspected an inflamed lymph node as the cause of the pain, likely due to an infection which could explain the high fever. As i performed my examination i observed that the pain was not typical of muscle injury or skeletal impairments. Updates are added as important new information is published. Intracavernosal agents used to treat erectile dysfunction. The lack of abnormalities in vitals signs despite serious. Priapism differential diagnoses medscape reference.
Christopher cheung approach to pediatric abdominal pain. Learn vocabulary, terms, and more with flashcards, games, and other study tools. Poor sensitivity of the history and physical exam broad differential diagnosis that crosses several specialties often negative diagnostic work up. We evaluated clinical and laboratory clues in the differential diagnosis of gynecological pathologies and acute appendicitis in patients of. Approach to pediatric abdominal pain learn pediatrics.
Evaluating abdominal pain requires an approach that relies on the likelihood of disease, patient history, physical examination, laboratory tests, and imaging studies. Play sporcle s virtual live trivia to have fun, connect with people, and get your trivia on. Acute abdominal pain in children pubmed central pmc. The differential diagnosis of rightsided abdominal pain by urban maes, m. The differential diagnosis of abdominal pain is extensive making a concise approach sometimes difficult. Common and important causes of acute abdominal pain for doctors and medical students. Remember, the differential diagnosis of a child varies depending on their age group. In elderly patients with abdominal pain, do not rely on descriptions of the classic presentation for diseases in the diagnosis of acute abdomen, and do not rely on the presence of fever or leukocytosis as a sign of infection.
Background the diagnosis of abdominal pain is difficult and often inaccurate. Differential diagnosis for abdominal pain acute home. Differential diagnoses in abdominal pain organized by time course. Linking this with the pathophysiology and anatomical location of abdominal pain is key to establishing a valid differential diagnosis. The diagnosis of priapism may be straightforward, depending on the physical findings.
Selected differential diagnosis of acute abdominal pain in children by. The majority of pediatric abdominal complaints are relatively benign e. Differential diagnosis of shoulder pain followed by. Abdominal pain, also known as a stomach ache, is a symptom associated with both nonserious and serious medical issues common causes of pain in the abdomen include gastroenteritis and irritable bowel syndrome. Differential diagnosis of acute abdominal pain micki raber, msn, fnpc, pnpc cindy herf, msn, fnpc slide 2. This study provides guidelines for the evaluation of acute abdominal pain in adults, including history and physical examination, diagnostic testing, and special patient populations. Differential diagnosis of acute abdomen is often carried out depending on the location of pain in abdominal quadrants and further characteristics of pain. The pain can arise due to various serious or nonserious causes. The age of the child can help focus the differential diagnosis. Parietal peritoneum inflammation results in more severe pain well localized to. Approximately 20% of patients evaluated for abdominal pain in the ed require hospitalet admission for intervention or.
The only abnormality found at the initial consultation was moderate tenderness in the right upper abdomen. Emergency laparotomy for peritonitis, bowel obstruction and other abdominal catastrophes is a high risk and high cost area of acute surgical care. 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 gain access to this resource from offcampus. Diagnostic approach to abdominal pain in adults robert m. Differential diagnosis in abdominal ultrasound 2nd edition pdf. We here present an interesting unusual case of upper abdominal pain. Postprandial abdominal pain is almost all the times caused by atherosclerosis of the mesenteric arteries. In select patients, diagnostic laparoscopy is occasionally considered when the diagnosis cannot be established by history, examination, or relevant diagnostic tests. Approach to pediatric abdominal pain general presentation background abdominal pain in a child is one of the most common presentations with both trivial and lifethreatening etiologies, ranging from functional pain to acute appendicitis. Cardinal presentations this post is part of a series called cardinal presentations, based on rosens emergency medicine 8th edition. 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.
Pdf diagnostic approach and management of acute abdominal. He had occasional neck pain over the past few years without any episodes of radiating pain from the cervical region into the shoulder or. Differential diagnosis for central abdominal pain acute. A patient presenting with abdominal pain to the general. Differential diagnosis for abdominal pain 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. Pdf on feb 1, 2004, dori l dahlberg and others published differential diagnosis. The differential diagnosis of rightsided abdominal pain. If a virtual private party is more your thing, go here for details. The differential diagnosis for abdominal pain is broad, encompassing gastrointestinal, gynecologic, urologic, vascular, and musculoskeletal. Acute right lower abdominal pain in women of reproductive age ncbi.
Evaluation of abdominal pain in the emergency department. A case report 17 his past medical history included a few episodes of stingers while playing rugby in college over 10 years ago. Abdominal pain in elderly persons differential diagnoses. A history and focused physical examination will lead to a differential diagnosis of abdominal pain, which will then inform. Differential diagnosis accesssurgery mcgrawhill medical. Abdominal pain differential escambia county, florida alsbls medical protocol approved. The differential diagnosis of abdominal pain is extensive and requires a logical evaluation. Differential diagnosis of abdominal pain in women of childbearing age. Differential diagnosis for abdominal pain acute oxford.
Rightsided upper abdominal pain is a common cause of presentation to general practitioners. Chronic abdominal pain diagnosis and management often challenging factors. Differential diagnosis in abdominal ultrasound 2nd edition pdf if you found this book helpful then please like, subscribe and share. Abdominal pain in children varies with age, associated symptoms, and pain location. Abdominal pain among older adults is a common complaint with broad differential diagnosis. The patient was a 38yearold man, who was admitted to our hospital complaining of right upper quadrant pain caused by a toothpick that perforated the anterior gastric wall and penetrated segment i of the liver. Other common diagnoses of abdominal pain in men and women are as follows. Af, cvs risk factors hypovolaemia shock soft abdomen pain out of proportion to exam v g. The emergency and nonurgent evaluation of abdominal pain of adults. Acute abdominal pain is a common complaint in childhood, and it can be caused by a wide range of underlying surgical and nonsurgical conditions. Pdf differential diagnosis of abdominal pain in women of. A read is counted each time someone views a publication summary such as the title, abstract, and list of authors, clicks on a figure, or views or downloads the fulltext.
Approach to abdominal pain department of emergency medicine. Abdominal pain is one of the most frequent complaints in primary care most patients with abdominal pain have minor, nonsurgical causes. 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 benign complaint, but it can also herald serious acute pathology. 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 for abdominal pain abdominal pain is a very common health problem that almost everyone of us have suffered from. The differential diagnosis of abdominal pain is the first book of a series of monographs to be published by the. Male female perforated ulcer nonspecific gastritis diverticulitis appendicitis acute cholecystitis the other factor is age over 70 years. Two important factors modify the differential diagnosis in patients who present with abdominal pain. Unusual differential diagnosis of upper abdominal pain. The pain did not resolve, and so he was seeking pt evaluation to identify if the cause was muscle or skeletal. Differential diagnosis of acute abdominal pain with. Diagnostic imaging of acute abdominal pain in adults american. The patient may have poorly localized pain and, given the wide differential diagnosis, a comprehensive history and examination are essential. About 15% of people have a more serious underlying condition such as appendicitis, leaking or ruptured abdominal aortic aneurysm, diverticulitis, or ectopic pregnancy.
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