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Periumbilical pain

  • Common ddx

    • gastroenteritis, adhesions, IBD, IBS
  • Don't miss

    • bowel obstruction, ileus, bowel ischemia/necrosis, appendicitis
  • Labs

    • CBC, chem
    • KUB if suspect obstruction (obstipation, hyperactive BS, distention)
    • FOBT and endoscopy if blood in stool
    • mesenteric angiogram if suspect ischemia/embolish (PMH afib or chronic abd pain after meals)
    • stool culture if foreign travel and diarrhea
    • CT if suspect pancreatitis
  • Other ddx

    • intussusception, mesenteric ischemia, trauma, parasites
  • ROS

    • quality, quantity, alleviation, aggravation
    • fever, wt loss
    • nausea, vomiting, diarrhea, constipation, blood in stool
    • PMH afib, atherosclerosis
    • past abdominal surgery
    • trauma
    • foreign travel, sick contacts
  • Px

    • inspection: guarding, distention, trauma
    • bowel sounds, abdominal aorta bruits
    • palpation: tenderness, rebound, mass

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    Disclaimer: MDHero Workups is for educational use only, and is not meant to replace the clinical judgement of a professional. We do not guarantee the accuracy of any information on this website.