Abdominal pain

Revision as of 22:34, 29 October 2010 by Robot (talk | contribs) (Created page with "==Workup== 1) B-hCG 2) CBC 3) Chem 7 4) LFTs 5) Lipase 6) UA/Gm stain/UCx 7) Guaiac 8) IVF 9) ECG (>50 yo) 10) ?CXR 11) ?Coags 12) ?contrast --> CT 13) ?US ==DD...")
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Workup

1) B-hCG

2) CBC

3) Chem 7

4) LFTs

5) Lipase

6) UA/Gm stain/UCx

7) Guaiac

8) IVF

9) ECG (>50 yo)

10) ?CXR

11) ?Coags

12) ?contrast --> CT

13) ?US


DDX

Killers

  • AAA
  • Mesenteric Ischemia
  • Bowel Perforation
  • Small Bowel Obstruction
  • Sigmoid Volvulus
  • Ectopic Pregnancy
  • Placental Abruption
  • MI


Diffuse

  • Peritonitis
  • Acute pancreatitis
  • Sickle cell crisis
  • Early appendicitis
  • Mesenteric thrombosis
  • Gastroenteritis
  • Dissecting/rupturing aneurysm
  • Intestinal obstruction
  • Diabetes


RUQ

  • Acute cholecystitis/biliary colic
  • Acute hepatitis
  • Hepatic abscess
  • Hepatomegaly due to CHF
  • Perforated duodenal ulcer
  • Acute pancreatitis (can be bilateral)
  • Retrocecal appendicitis
  • Herpes zoster
  • Myocardial ischemia
  • Right lower lobe pneumonia
  • Bowel obstruction


Epigastric

  • Gallbladder disease
  • GERD
  • PUD
  • Gastritis
  • Acute pancreatitis
  • Splenic enlargement/rupture/infarction/aneurysm
  • Myocardial ischemia
  • Pericarditis/Myocarditis
  • Aortic dissection


LUQ

  • Gastritis
  • Acute pancreatitis
  • Splenic enlargement/rupture/infarction/aneurysm
  • Myocardial ischemia
  • Left lower lobe pneumonia


RLQ

  • Appendicitis
  • Regional enteritis
  • Meckel's diverticulitis
  • Cecal diverticulitis
  • Leaking aneurysm
  • Abdominal wall hematoma
  • Ruptured ectopic
  • Twisted ovarian cyst


LLQ

  • Sigmoid diverticulitis
  • Leaking aneurysm
  • Ruptured ectopic
  • Mittleshmerz
  • Twisted ovarian cyst


Pelvic

  • Mittelschmerz
  • Endometriosis
  • Ureteral calculi
  • Seminal vesiculitis
  • Psoas abscess
  • Mesenteric adenitis
  • Incarcerated hernia
  • Endometriosis


Extra-Abdominal

  • MI
  • Aortic Dissection
  • AAA
  • PNA
  • PE
  • Testicular Torsion
  • Herpes zoster
  • Muscle spasm
  • Strep pharyngitis (children)
  • Mononucleosis
  • DKA
  • ETOH ketoacidosis
  • Uremia
  • Sickle cell disease
  • Porphyria
  • SLE
  • Vasculitis
  • Glaucoma
  • Hyperthyroidsim
  • Methanol poisoning
  • Heavy metal toxicity
  • Addison's Disease
  • Acute Porphyria


Source

3/20/06 DONALDSON (adapted from Rosen)

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