Epigastric abdominal pain: Difference between revisions
Neil.m.young (talk | contribs) (Text replacement - "==Sources==" to "==References==") |
|||
| (8 intermediate revisions by 3 users not shown) | |||
| Line 1: | Line 1: | ||
==Background== | ==Background== | ||
*This page outlines the general approach to adult epigastric pain | *This page outlines the general approach to adult epigastric pain | ||
{{Abdominal pain location}} | |||
==Clinical Features== | ==Clinical Features== | ||
*Pain in the epigastrum | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
{{Template:Abdominal Pain DDX Epigastric}} | {{Template:Abdominal Pain DDX Epigastric}} | ||
==Workup== | ==Evaluation== | ||
===Workup=== | |||
*CBC | *CBC | ||
*Chem | *Chem | ||
*LFTs | *[[LFTs]] | ||
*Lipase | *Lipase | ||
*Coags | *Coags | ||
* | *[[Urinalysis]] | ||
*Urine pregnancy (females) | *Urine pregnancy (females) | ||
*?ECG (if >50 or at risk for cardiac disease) | *?[[ECG]] (if >50 or at risk for cardiac disease) | ||
*?[[RUQ US]] | *?[[RUQ US]] | ||
*?CXR | *?[[CXR]] | ||
**Consider if at risk for perforated ulcer | **Consider if at risk for perforated ulcer | ||
===Diagnosis=== | |||
==Management== | ==Management== | ||
*Treat underlying disease process | *Treat underlying disease process | ||
*Consider GI | *Consider PO antacid (e.g. [[Bismuth subsalicylate|Maalox]] Plus) | ||
**The addition of viscous [[lidocaine]] 2% and/or Donnatol (i.e. "GI Cocktail") is no more effective than plain liquid antacid<ref>Berman DA, Porter RS, Graber M. "The GI Cocktail is no more effective than plain liquid antacid: a randomized, double blind clinical trial." J Emerg Med. 2003 Oct;25(3):239-44.</ref> | |||
==Disposition== | ==Disposition== | ||
| Line 37: | Line 44: | ||
[[Category:GI]] | [[Category:GI]] | ||
[[Category:Symptoms]] | |||
Latest revision as of 22:37, 31 January 2024
Background
- This page outlines the general approach to adult epigastric pain
Classification by Abdominal pain location
| RUQ pain | Epigastric pain | LUQ pain |
| Flank pain | Diffuse abdominal pain | Flank pain |
| RLQ pain | Pelvic pain | LLQ pain |
Clinical Features
- Pain in the epigastrum
Differential Diagnosis
Epigastric Pain
- Gastroesophageal reflux disease (GERD)
- Peptic ulcer disease with or without perforation
- Gastritis
- Pancreatitis
- Gallbladder disease
- Myocardial Ischemia
- Splenic Infarctionenlargement/rupture/aneurysm
- Pericarditis/Myocarditis
- Aortic dissection
- Hepatitis
- Pyelonephritis
- Pneumonia
- Pyogenic liver abscess
- Fitz-Hugh-Curtis Syndrome
- Hepatomegaly due to CHF
- Bowel obstruction
- SMA syndrome
- Pulmonary embolism
- Bezoar
- Ingested foreign body
Evaluation
Workup
- CBC
- Chem
- LFTs
- Lipase
- Coags
- Urinalysis
- Urine pregnancy (females)
- ?ECG (if >50 or at risk for cardiac disease)
- ?RUQ US
- ?CXR
- Consider if at risk for perforated ulcer
Diagnosis
Management
- Treat underlying disease process
- Consider PO antacid (e.g. Maalox Plus)
Disposition
- Disposition per underlying disease process
See Also
External Links
References
- ↑ Berman DA, Porter RS, Graber M. "The GI Cocktail is no more effective than plain liquid antacid: a randomized, double blind clinical trial." J Emerg Med. 2003 Oct;25(3):239-44.