Therefore, the differential diagnosis of abdominal pain can be organized based on whether patients are presenting with their first episode of acute abdominal pain, a recurrent episode of acute abdominal pain, or chronicsubacute abdominal pain. Laboratory examination showed a white cell count of 12 200 gdl and a creactive protein of 9. Start studying differential diagnosis of nv without abdominal pain. Acute abdominal pain is one of the most common complaints in childhood, and one that frequently requires rapid diagnosis and treatment in the emergency department. Ogd, barium meal and ph study helicobacter pylori often present in mucosa or by serology. 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. The intensity of the pain may often scare us, but it is not necessarily due to something serious. Data examined included demographic features of patients, duration of back pain, muscles involved, primary diagnosis, treatment modality and response to treatment. Common causes of gastrointestinal pain include gastroenteritis, such as an infectious gastroenteritis, along with the. Use low threshold for admiting elderly and immunocompromised for observation. Abdominal pain is a common presentation in the outpatient setting and is challenging to diagnose.
There are a variety of conditions that may cause acute abdominal pain in a child. The differential diagnosis of abdominal pain is extensive making a concise approach sometimes difficult. Sonography and computed tomography revealed a circular swelling of the anterior gastric wall up to 21 mm in diameter and an inflammatory process. Find abdominal pain diagnosis information, treatments for abdominal pain diagnosis and abdominal pain diagnosis symptoms. 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. Four presentations of abdominal swellings, including paraumbilical hernia, umbilical hernia, umbilical granuloma. Acute abdominal pain in children differential diagnosis.
Clinical scoring for diagnosis of acute lower abdominal. Evaluation of abdominal pain in children differential. Interesting and unusual cases of chronic abdominal pain. The differential diagnosis is lengthy, differs from that in adults, and varies by. A diagnosis of pediatrie frap is defined by the rome. Diagnosis and management of acute abdominal pain for students slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Pdf diagnostic approach and management of acute abdominal. The patient states that she has had progressively worsening lower abdominal pain for the past three weeks. Differential diagnosis of acute abdominal pain oscestop. Differential diagnosis of recurrent abdominal pain. Diagnosing the cause of abdominal pain can be difficult, because many diseases can cause this symptom. If you continue browsing the site, you agree to the use of cookies on this website. Neurologic basis for abdominal pain pain receptors in the abdomen respond to mechanical and chemical stimuli.
Abdominal pain causes and diagnosis symptom information. The isabel healthcare 1 minute read program highlights various diseases and conditions, providing the isabel tool differential list. With abdominal pain, it is important to determine what the cause is by taking a good history and the cause of the pain like how the pain begins, the. Abdominal examination revealed right upper quadrant pain with neither guarding nor rebound.
Approach to pediatric abdominal pain learn pediatrics. Blunt force injuries to the abdomen can generally be explained by 3. Cohorts with atypical presentations of serious abdominal pain causes. Differential diagnosis of nv without abdominal pain. Acute abdominal pain in children pubmed central pmc.
Differential diagnosis of pain in the upper abdomen thomas p. Other common diagnoses of abdominal pain in men and women are as follows. Cardinal presentations this post is part of a series called cardinal presentations, based on rosens emergency medicine 8th edition. Differential diagnosis for central abdominal pain acute.
A sh is generally an interparietal hernia, meaning that the preperitoneal fat and the hernia sac penetrate the trasnversus abdominis and internal oblique muscles but remain behind the external oblique aponeurosis. Acute abdominal pain msd manual professional edition. Abdominal organs produce symptoms based on their location, e. Pain in the upper abdomen is a common complaint in medical practice. Understanding hepatic vein thrombosis buddchiari syndrome hepatic vein thrombosis hvt is an obstruction in the veins of the liver caused by a blood clot. The majority of pediatric abdominal complaints are relatively benign e. Pdf a differential diagnosis in chronic lower abdominal pain. Subscribe to the isabel blog to receive clinical content and articles abdominal pain differential diagnosis. The incidence and prevalence is unknown, may be due to under reporting or under 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.
Abdominal pain is one of the more common problems that may affect more than 90% of the population. Abdominal pain in elderly persons differential diagnoses. Male female perforated ulcer nonspecific gastritis diverticulitis appendicitis acute cholecystitis the other factor is age over 70 years. Assessment of chronic abdominal pain differential diagnosis of. 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.
An otherwise well 46yearold woman presented to her general practitioner with intermittent abdominal pain that had been present for several months. Most frequently the cause is benign andor selflimiting, but more serious causes may require urgent intervention. Christopher cheung approach to pediatric abdominal. A patient presenting with abdominal pain to the general. 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. Pdf the incidence of acute abdominal pain ranges between 510% of all visits at. Differential diagnosis for abdominal pain acute oxford. Assessment and differential diagnosis of abdominal pain. She describes the pain as constant, cramping, currently 810 in severity with radiation to the right flank.
Of particular importance are pain location see figure location of abdominal pain and possible causes and characteristics, history of similar symptoms, and associated symptoms. A differential diagnosis in chronic lower abdominal pain article pdf available in international journal of surgery case reports 310. Differential diagnosis of acute abdominal pain by age. 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. Differential diagnoses in abdominal pain organized by time course.
Differential diagnosis accesssurgery mcgrawhill medical. A retrospective data analysis was performed on 542 female patients who were admitted to a tertiary care hospital with a chief complaint of acute. Differential diagnosis of abdominal pain flashcards quizlet. A differential diagnosis in chronic lower abdominal pain. Abdominal pain as a chief complaint can present a significant diagnostic challenge in the primary care setting.
Gastric volvulus may be transient producing few symptoms. The age of the child determines the differential diagnosis. Timely and correct diagnosis is clinically challenging. 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. The only abnormality found at the initial consultation was moderate tenderness in the right upper abdomen. A thorough history usually suggests the diagnosis see table history in patients with acute abdominal pain. Obstetrics and gynecological conditions obgync are difficult to be differentiated from appendicitis in young adult females presenting with acute lower abdominal pain. However, lingering symptoms can indicate a chronic disease that should be treated. Abdominal pain can be caused by hundreds of disorders, ranging from mild to lifethreatening. Intraabdominal injuries secondary to blunt force are attributed to collisions between the injured person and the external environment and to acceleration or deceleration forces acting on the persons internal organs. Triage and disposition acute abdominal pain frequently requires. Assessment of abdominal pain in children differential.
Differential diagnosis for central abdominal pain acute common and important causes of central abdominal pain acute for doctors and medical students this page is. Feverweaknesssyncopealtered mental statusseizuredizziness and vertigoheadachesore throatdyspneachest painabdominal painnausea and vomitinggastrointestinal bleedingacute pelvic painback pain pathophysiology of abdominal pain. A history and focused physical examination will lead to a differential diagnosis of abdominal pain, which will then inform. The frequency of abdominal pain as a symptom in patients with aids is unknown. Stretch is the principal mechanical stimulus involved in visceral nociception, although distention, contraction, traction, compression, and torsion are also perceived 1. This article will tell you about the various diagnosis for abdominal pain, arising in different parts of your abdomen. Select a symptom or disease and get instant differential diagnosis information. Unusual differential diagnosis of upper abdominal pain. The differential diagnosis of abdominal pain is extensive and requires a logical evaluation. This video relates abdominal pain according to different abdominal regions and states the most important differential diagnosis of each pain position.
Chronic intermittent gastric volvulus is a rare disease that requires high index of suspicion for diagnosis and treatment. Abdominal pain diagnosis medhelps abdominal pain diagnosis center for information, symptoms, resources, treatments and tools for abdominal pain diagnosis. Differential diagnosis of pediatric acute 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. Differential diagnosis of abdominal pain according to. Pdf on feb 1, 2004, dori l dahlberg and others published differential diagnosis of abdominal pain in women of childbearing age. Visceral receptors responsible for these sensations. In most cases, a thorough history and physical exam can narrow the broad differential. Abdominal pain is a very common health problem that almost everyone of us have suffered from.
We here present an interesting unusual case of upper abdominal pain. A more complete differential diagnosis of abdominal pain and its. Because of the spectrum of etiologies that manifest as abdominal pain, the differential remains broad and diagnosis can be challenging. It is a common problem and, although the vast majority of these episodes are benign and selflimiting, persistent abdominal pain may signify an underlying pathology requiring urgent intervention. Differential diagnosis of pain in the upper abdomen. The pain may be coming from the gastrointestinal system stomach, intestines, urinary system, reproductive organs, biliary system, and other organs. Two important factors modify the differential diagnosis in patients who present with abdominal pain. Pdf differential diagnosis of abdominal pain in women of. This study provides guidelines for the evaluation of acute abdominal pain in adults, including history and physical examination, diagnostic testing, and special patient populations. The pain can arise due to various serious or nonserious causes. Table 31 outlines the typical time course associated with different diseases causing abdominal pain. Evaluation of acute abdominal pain in adults american. The differential diagnosis of abdominal pain is the first book of a series of monographs to be published by the.
Evaluation of abdominal pain in the emergency department. The code is valid for the year 2020 for the submission of hipaacovered transactions. Paediatric abdominal pain is often a diagnostic dilemma. Learn vocabulary, terms, and more with flashcards, games, and other study tools. Although acute abdominal pain is typically selflimiting and benign, there are potentially lifethreatening conditions that require urgent management, such as appendicitis. Differential diagnosis when evaluating a patient with acute abdominal pain. Timely evaluation and intervention are critical in preventing untoward sequelae in children presenting with abdominal pain.