Get this App offline and editable on your phone

iPhone & iPad | Android | PC | Mac

Abdominal pain

  • Common ddx

    • gastroenteritis, IBD, UTI, PID, GERD, gastritis, pancreatitis, gallstone, IBS
  • Don't miss

    • appendicitis, pancreatitis, diverticulitis, pregnancy, hepatitis, bowel obstruction, colorectal cancer, trauma, atypical MI, malignancy, DKA
  • Labs

    • CBC, chem panel
    • consider lipase, amylase, LFTs, lactate, ESR
    • UA if lower abdominal pain
    • hCG if female, reproductive age, and acute
    • FOBT if suspect bleed
    • stool studies if suspect parasite
    • EKG, enzymes if elderly and acute
    • abdominal xray if acute and worrisome
    • abdominal 3 way film including KUB if suspect obstruction
    • CXR if suspect pneumonia
    • US if suspect gallstone
    • CT if suspect appendicitis, diverticulitis or kidney stone
    • endoscopy if suspect malignancy
    • angiography if suspect aneurysm, mesenteric ischemia
    • surg consult, ex-lap if shock
  • ED Tx

    • make NPO
    • IV hydration
    • pain meds can mask symptoms, use judiciously
    • antiemetics:
      • ondansetron 4 mg IM/IV
      • or metoclopramide 10 mg IM or slow IV
    • antibiotics if suspect infection
      • gentamicin 1.5 mg/kg IV + metronidazole 1 g IV
      • or piperacillin-tazobactam 3.375 g IV
    • Consider surgical, OBGyn consult
  • Other ddx

    • pneumonia, pleural effusion, muscle injury
  • Epigastric ddx

    • esophageal issue, gastritis, PUD, stomach cancer, pancreatitis
  • RUQ ddx

    • gallstone, hepatitis
  • LUQ ddx

    • gastritis, PUD, stomach cancer, mono, splenic rupture
  • RLQ ddx

    • appendicitis, IBD, UTI, ureter stone, OBGYN issues
  • LLQ ddx

    • diverticulitis, colorectal cancer, IBD, proctitis, UTI, ureteral stone, OBGYN issues
  • Suprapubic ddx

    • UTI, urine retention, bladder cancer, prostate, OBGYN issues
  • Periumbilical ddx

    • gastroenteritis, obstruction, ileus, ischemia, intussusception, mesenteric ischemia, adhesions, appendicitis
  • Generalized ddx

    • gastroenteritis, obstruction, ileus, IBD, peritonitis, ascites, DKA, sickle cell, lead poisoning
  • OBGYN ddx

    • mittelschmerz, anovulation, PCOS, PID, ectopic pregnancy, ovarian torsion, endometritis, cervicitis
  • Men ddx

    • BPH, prostate cancer
  • HPI

    • location
    • quality
    • quantity
    • alleviation
    • aggravation
    • pain currently
  • ROS

    • fever, wt loss
    • trauma
    • chest pain, dyspnea
    • dysuria, blood in urine, urethral discharge, vaginal discharge
    • dysphagia, nausea, vomiting, diarrhea, constipation, blood in stool
    • EtOH usage, lead exposure
    • OBGYN ROS: LMP, sexual hx, new partners, vaginal discharge
  • PMH

    • diabetes, sickle cell
  • FH

    • colorectal cancer, IBD, sickle cell
  • Px

    • vitals: fever, BP
    • mental status, distress
    • cardio, pulm
    • abd inspection: guarding, distention
    • bowel sounds
    • palpation: mass, tenderness, rebound
  • Tx

    • rehydration if vomiting, diarrhea
    • bowel rest, NG suction if obstruction

  • Print | Citations

    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.