Abdominal pain: Difference between revisions

No edit summary
No edit summary
Line 48: Line 48:
#[[Mesenteric Ischemia]]
#[[Mesenteric Ischemia]]
#[[Gastroenteritis]]
#[[Gastroenteritis]]
===Epigastric===
#[[Gallbladder Disease (Main)]]
#GERD
#PUD
#Gastritis
#[[Pancreatitis]]
#Splenic enlargement/rupture/infarction/aneurysm
#Myocardial ischemia
#[[Pericarditis]]/Myocarditis
#[[Aortic Dissection]]


===RUQ===
===RUQ===
Line 64: Line 75:
#Pulmonary embolism
#Pulmonary embolism


===Epigastric===
#[[Gallbladder Disease (Main)]]
#GERD
#PUD
#Gastritis
#[[Pancreatitis]]
#Splenic enlargement/rupture/infarction/aneurysm
#Myocardial ischemia
#[[Pericarditis]]/Myocarditis
#[[Aortic Dissection]]
===LUQ===
===LUQ===
#Gastritis/gastric ulcer
#Gastritis/gastric ulcer
Line 105: Line 105:
   
   
===LLQ===
===LLQ===
#Aortic aneurysm (leaking, ruptured)
#Aortic aneurysm (leaking, ruptured)
#Diverticulitis (sigmoid)
#Diverticulitis (sigmoid)
Line 123: Line 122:


===Pelvic===
===Pelvic===
#Mittelschmerz
====Abdominal origin====
#Endometriosis
#Ureteral calculi ([[Kidney Stone]])
#Ureteral calculi ([[Kidney Stone]])
#Seminal vesiculitis
#Psoas abscess
#Psoas abscess
#Mesenteric adenitis
#Mesenteric adenitis
#Incarcerated hernia
#Incarcerated hernia
====Pelvic origin====
#Ectopic
#Adnexal torsion
#Endometriosis
#PID
#Myoma (degenerating)
#Ovarian cyst (rupture)
#Tubo-ovarian abscess
#Mittelschmerz
#Endometriosis
#Endometriosis
#Seminal vesiculitis


===Extra-Abdominal===
===Extra-Abdominal===
#[[MI]]
#[[MI]]
#[[Aortic Dissection]]
#[[Aortic Dissection]]
#[[AAA]]
#[[PNA]]
#[[PNA]]
#[[PE]]
#[[PE]]
Line 141: Line 147:
#Herpes zoster
#Herpes zoster
#Muscle spasm
#Muscle spasm
#[[Strep Pharyngitis]] (children)
#[[Strep Pharyngitis]] (peds)
#Mononucleosis
#Mononucleosis
#[[DKA]]
#[[DKA]]
Line 147: Line 153:
#Uremia
#Uremia
#Sickle cell disease
#Sickle cell disease
#Porphyria
#SLE
#SLE
#Vasculitis
#Vasculitis
Line 155: Line 160:
#Heavy metal toxicity
#Heavy metal toxicity
#Addison's Disease  
#Addison's Disease  
#Acute Porphyria
#Porphyria


==Source ==
==Source ==

Revision as of 05:54, 25 July 2011

Background

  • Pts with immunosuppression often have delayed or atypical presentations

Workup

  1. Urine pregnancy
  2. CBC
    1. A single WBC cannot exclude surgical disease
  3. Chemistry
  4. LFTs
  5. Lipase
    1. May be normal early in course of pancreatitis
  6. UA/UCx
  7. Guaiac
  8. ECG (>40 yo)
  9. ?CXR
  10. ?Coags
    1. GI bleeding, end-stage liver disease, coagulopathy
  11. ?Lactate
  12. ?Abd X-ray
    1. Consider for r/o obstruction, perforation, or severe constipation
  13. ?US
  14. ?CT

DDX

Killers

  1. AAA
  2. Mesenteric Ischemia
  3. Bowel Perforation
  4. Small Bowel Obstruction
  5. Sigmoid Volvulus
  6. Ectopic Pregnancy
  7. Placental Abruption
  8. ACS

Diffuse

  1. Peritonitis
  2. Pancreatitis
  3. Appendicitis (early)
  4. Aortic aneurysm (leaking, ruptured)
  5. Aortic dissection
  6. Small Bowel Obstruction
  7. Diabetic gastric paresis
  8. Mesenteric Ischemia
  9. Diabetic Ketoacidosis
  10. Bowel perforation
  11. Volvulus
  12. Sickle Cell Crisis
  13. Mesenteric Ischemia
  14. Gastroenteritis

Epigastric

  1. Gallbladder Disease (Main)
  2. GERD
  3. PUD
  4. Gastritis
  5. Pancreatitis
  6. Splenic enlargement/rupture/infarction/aneurysm
  7. Myocardial ischemia
  8. Pericarditis/Myocarditis
  9. Aortic Dissection

RUQ

  1. Gallbladder Disease (Main)
  2. Appendicitis (retrocecal)
  3. Hepatitis
  4. Hepatic abscess
  5. Fitz-Hugh-Curtis Syndrome
  6. Hepatomegaly due to CHF
  7. Perforated duodenal ulcer
  8. Pancreatitis
  9. Herpes zoster
  10. Myocardial ischemia
  11. Pneumonia
  12. Bowel obstruction
  13. Pulmonary embolism

LUQ

  1. Gastritis/gastric ulcer
  2. Herpes Zoster
  3. Pancreatitis
  4. Splenic rupture/distension
  5. Myocardial Ischemia
  6. Pneumonia
  7. Pulmonary Embolism

RLQ

  1. Appendicitis
  2. Aortic aneurysm (leaking, ruptured)
  3. Crohn disease (terminal ileitis)
  4. Diverticulitis (cecal)
  5. Ectopic
  6. Endometriosis
  7. Epiploic appendagitis
  8. Herpes zoster
  9. Inguinal hernia
  10. Ischemic colitis
  11. Meckel diverticulum
  12. Mittelschmerz
  13. Ovarian cyst (ruptured)
  14. Ovarian torsion
  15. PID
  16. Psoas abscess
  17. Testicular torsion
  18. Kidney stone

LLQ

  1. Aortic aneurysm (leaking, ruptured)
  2. Diverticulitis (sigmoid)
  3. Ectopic
  4. Endometriosis
  5. Epiploic appendagitis
  6. Herpes Zoster
  7. Inguinal hernia
  8. Ischemic colitis
  9. Mittelschmerz
  10. Ovarian cyst (ruptured)
  11. Ovarian torsion
  12. PID
  13. Psoas abscess
  14. Testicular torsion
  15. Kidney stone

Pelvic

Abdominal origin

  1. Ureteral calculi (Kidney Stone)
  2. Psoas abscess
  3. Mesenteric adenitis
  4. Incarcerated hernia

Pelvic origin

  1. Ectopic
  2. Adnexal torsion
  3. Endometriosis
  4. PID
  5. Myoma (degenerating)
  6. Ovarian cyst (rupture)
  7. Tubo-ovarian abscess
  8. Mittelschmerz
  9. Endometriosis
  10. Seminal vesiculitis

Extra-Abdominal

  1. MI
  2. Aortic Dissection
  3. PNA
  4. PE
  5. Testicular Torsion
  6. Herpes zoster
  7. Muscle spasm
  8. Strep Pharyngitis (peds)
  9. Mononucleosis
  10. DKA
  11. ETOH ketoacidosis
  12. Uremia
  13. Sickle cell disease
  14. SLE
  15. Vasculitis
  16. Glaucoma
  17. Hyperthyroidsim
  18. Methanol poisoning
  19. Heavy metal toxicity
  20. Addison's Disease
  21. Porphyria

Source

Tintinalli

Retrieved from "https://www.wikem.org/w/index.php?title=Abdominal_pain&oldid=4887"