...
Is there a family history of migraine or epilepsy? Migraine and epilepsy both present with abdominal pain.
Is the pain colicky ... DIAGNOSTIC WORKUP
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Where is the pain located? If it is diffuse, one should consider pancreatitis, mesenteric artery occlusion, or ruptured peptic ulcer. In addition, another viscus may be perforated, such as a ruptured ... DIAGNOSTIC WORKUP
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Is there tenderness and rebound tenderness? If this is absent, consider voluntary rigidity. If this is present, the finding must be considered serious.
Is ... DIAGNOSTIC WORKUP
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Is it in the right upper quadrant? A mass in the right upper quadrant is most often an enlarged liver. However, the liver may be pushed down by a subphrenic abscess, and there may be an enlarged ... DIAGNOSTIC WORKUP
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Is there hepatomegaly? If there is hepatomegaly, one should suspect congestive heart failure, emphysema, constrictive pericarditis, hepatic vein thrombosis, and ... DIAGNOSTIC WORKUP
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Is there a history of alcohol or drug ingestion? Alcohol and many drugs such as digitalis, aspirin, nonsteroidal anti-inflammatory agents ... DIAGNOSTIC WORKUP
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Lower abdominal pain is a common complaint that must be evaluated carefully and systematically to reach the appropriate diagnosis in timely manner. All diagnoses must be considered, with the most emergent... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Upper abdominal pain is a common presenting symptom. A complete differential diagnosis should be developed based on the organs in the upper abdomen in addition to the associated history... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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In evaluating an acute abdomen, rebound tenderness is one of the most important signs of peritonitis. It is elicited by pressing deeply on the abdomen and then suddenly releasing... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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An abdominal bruit is a murmur that corresponds to the cardiac cycle. It is heard best with the diaphragm of the stethoscope, usually over the abdominal aorta, renal arteries, or spleen. It can be a sign of... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Abdominal distension is a common complaint that must be evaluated carefully and systematically to expediently rule out serious and life-threatening diagnoses and evaluate for mundane diagnoses,... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Abdominal guarding refers to muscular rigidity of the abdomen upon palpation. It may be involuntary or voluntary. The examiner may try to limit the voluntary guarding during the physical examination by having the patient bend both knees and... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Many disease processes, including malignancies, infections, and bowel obstruction, present with abdominal masses. The most serious and dramatic etiology is an abdominal aortic aneurysm, which is responsible for... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Vomiting is an involuntary forceful extrusion of stomach contents. It is a mediated by a complex reflex that is located in the vomiting center of the medulla oblongata. Reflex vomiting... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Abdominal pain is a frequent complaint and associated with an enormous number of causes. Many causes of acute abdominal pain require surgical intervention, so a prompt diagnosis is needed. Diagnostic clues would include the location of the... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Vomiting is the forceful expulsion of gastric contents through the mouth that involves an integrated and largely somatic motor response. It represents a protective reflex in the body's... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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A prominent “potbelly” contour is normal in infants and young children. Pathologic enlargement of the abdomen is a fairly common problem that can result from reduced tone of... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Abdominal masses are common presenting signs of malignant solid tumors in children and should be presumed to be such. They require urgent evaluation to rule out compression of internal organs, hemorrhage, and... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Projectile vomiting is the forceful expulsion of stomach contents classically associated with pyloric stenosis. Although pyloric stenosis is one cause, there are many other causes inside and outside the GI tract.
... Workup and Diagnosis ... Treatment
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... The GI tract is the only “organ” that really covers the abdomen from one end to the other. Anything that causes an irritation of all or a large portion of this “tube” may
... READ MEDICAL BOOK EXCERPTS ONLINE » (free access, no registration)
... As the physician examines the abdomen, how can he or she recall all of the causes of a mass or swelling? The physician should consider the possibilities for the mass’s composition. It may be air, in which
... READ MEDICAL BOOK EXCERPTS ONLINE » (free access, no registration)
... These two should be considered together, because nausea is just a forme fruste of vomiting. This symptom lends itself well to anatomic analysis, particularly by the
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... Abdominal distention refers to increased abdominal girth — the result of increased intra-abdominal pressure forcing the abdominal wall outward. Distention may be mild or severe... Emergency interventions ... History and physical examination ... Medical causes ... Special considerations
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... Commonly detected on routine physical examination, an abdominal mass is a localized swelling in one abdominal quadrant. Typically, this sign develops insidiously and may represent an enlarged organ, a neoplasm, an abscess, a vascular... Emergency interventions ... History and physical examination ... Medical causes ... Special considerations ... Pictures
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... Abdominal pain usually results from a GI disorder, but it can be caused by a reproductive, genitourinary (GU), musculoskeletal, or vascular disorder; drug use; or ingestion of toxins.... Emergency interventions
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... Dyspepsia refers to an uncomfortable fullness after meals that's associated with nausea, belching, heartburn and, possibly, cramping and abdominal distention. Frequently aggravated by spicy, fatty, or... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pictures
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... Vomiting is the forceful expulsion of gastric contents through the mouth. Characteristically preceded by nausea, vomiting results from a coordinated sequence of abdominal muscle... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Pictures
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... Detected by palpation, abdominal rigidity refers to abnormal muscle tension or inflexibility of the abdomen. Rigidity may be voluntary or involuntary. Voluntary rigidity reflects the patient... Emergency interventions ... History and physical examination ... Medical causes ... Special considerations ... Pictures
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... Mechanical Bowel Obstruction
Extraluminal compression
Congenital abnormalities
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... Diffuse
Gastroenteritis
Peritonitis
Pancreatitis
Leukemia
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... Abdominal Disorders
Inflammatory disorders
Peritoneum
Peritonitis (chemical or bacterial)
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... Central Nervous System Disorders
Increased intracranial pressure
Head trauma
Central nervous
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... Signs and Symptoms Pulsating mass in periumbilical area, systolic bruit over aorta, tenderness with deep palpation, flank and groin pain, weakness, sweating, tachycardia, hypotension
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... Abdominal aneurysm, an abnormal dilation in the arterial wall, generally occurs in the aorta between the renal arteries and iliac branches. Rupture — in which the aneurysm breaks... Causes and incidence ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations ... Pictures
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... Blunt and penetrating abdominal injuries may damage major blood vessels and internal organs. Their most immediate life-threatening consequences are hemorrhage and hypovolemic shock; later threats... Causes and incidence ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations ... Pictures
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... Signs and Symptoms Pallor, cyanosis, pain, tachycardia, dyspnea, hypotension, bruising, abdominal distention and rigidity
Treatment (Tx) I.V.
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... Abdominal distention refers to increased abdominal girth—the result of increased intra-abdominal pressure forcing the abdominal wall outward. Distention may be mild or severe, depending on the amount of pressure. It may be... Emergency interventions ... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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... Commonly detected on routine physical examination, an abdominal mass is a localized swelling in one abdominal quadrant. Typically, this sign develops insidiously and may represent an enlarged organ, a... Emergency interventions ... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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... Abdominal pain usually results from a GI disorder, but it can also be caused by a reproductive, genitourinary (GU), musculoskeletal, or vascular disorder; drug use; or... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Pictures
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Dyspepsia
(Professional Guide to Signs & Symptoms (Fifth Edition))
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... Dyspepsia refers to an uncomfortable fullness after meals that’s associated with nausea, belching, heartburn and, possibly, cramping and abdominal distention. Frequently aggravated by spicy, fatty, or high-fiber foods and by... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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Vomiting
(Professional Guide to Signs & Symptoms (Fifth Edition))
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... Vomiting is the forceful expulsion of gastric contents through the mouth. Characteristically preceded by nausea, vomiting results from a coordinated sequence of abdominal... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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... Detected by palpation, abdominal rigidity refers to abnormal muscle tension or inflexibility of the abdomen. Rigidity may be voluntary or involuntary. Voluntary rigidity reflects the patient&rsquo... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Pictures
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Abdominal Pain
(The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter)
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... Richard W. Emerine
Abdominal pain of varying causes, ranging from the functional to the organic, is one of the top ten outpatient complaints; it is the chief... Approach ... History ... Physical examination ... Testing ... Diagnostic assessment
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Nausea and Vomiting
(The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter)
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... Eric M. Walsh
Approach Nausea and vomiting are common presenting complaints in office practice. An effective diagnostic approach will consider causes both within the gastrointestinal (GI) system, and systemic... History. ... Physical examination. ... Testing. ... Diagnostic assessment
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... Differential Overview
❑ Irritable bowel syndrome
❑ Peptic ulcer disease
❑ Cholecystitis
❑... Diagnostic Approach ... Clinical Findings
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... Differential Overview
Generalized/Periumbilical
❑ Gastroenteritis
❑ Obstipation
... Diagnostic Approach ... Clinical Findings ... Pictures
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... Differential Overview
Abdominal Mass
❑ Liver enlargement
❑ Spleen enlargement
... Diagnostic Approach ... Clinical Findings
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... Differential Overview
Ascites
❑ Right-sided heart failure
❑ Cirrhosis
❑ Hypoalbuminemia ... Diagnostic Approach ... Clinical Findings ... Pictures
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... Differential Overview
Presenting Symptom
❑ Gastroesophageal reflux
❑ Pregnancy
... Diagnostic Approach ... Clinical Findings
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... With abdominal aneurysm, an abnormal dilation in the arterial wall generally occurs in the aorta between the renal arteries and iliac branches. Such aneurysms are four times... Causes ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations ... Pictures
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... Blunt and penetrating abdominal injuries may damage major blood vessels as well as internal organs. Their most immediate life-threatening consequences are hemorrhage and hypovolemic shock; later threats include... Causes ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
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Abdominal pain
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)
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... Abdominal pain usually results from a GI disorder, but can also be caused by drug use, ingestion of toxins, or disorders of the reproductive, genitourinary (GU), musculoskeletal, or vascular systems. At times, such pain signals... Assessment ... History ... Physical examination ... Pediatric pointers ... Geriatric pointers ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
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Vomiting
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)
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... Vomiting is the forceful expulsion of gastric contents through the mouth. Characteristically preceded by nausea, vomiting results from a coordinated sequence of abdominal muscle contractions and reverse esophageal peristalsis. ... Assessment ... History ... Physical examination ... Pediatric pointers ... Geriatric pointers ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
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Abdominal rigidity
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)
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... Abdominal rigidity has been described as abnormal muscle tension or inflexibility of the abdomen, and as an abdominal muscle spasm with involuntary guarding. Rigidity is detected by... Assessment ... History ... Physical examination ... Pediatric pointers ... Geriatric pointers ... Medical causes ... Nursing considerations ... Patient teaching ... Pictures
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... Abdominal distention refers to increased abdominal girth — the result of increased intra-abdominal pressure forcing the abdominal wall outward. Distention may be mild or severe,... Emergency Actions ... History ... Physical assessment ... Medical causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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... Commonly detected on routine physical examination, an abdominal mass is a localized swelling in one abdominal quadrant. Typically, this sign develops insidiously and may represent an enlarged organ, a... Emergency Actions ... History ... Physical assessment ... Medical causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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... Abdominal pain usually results from a GI disorder, but it can be caused by a reproductive, genitourinary (GU), musculoskeletal, or vascular disorder; drug use; or ingestion of toxins. At times, such pain signals life-threatening complications... Emergency Actions ... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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... Dyspepsia refers to an uncomfortable fullness after meals that’s associated with nausea, belching, heartburn and, possibly, cramping and abdominal distention. Frequently aggravated by spicy, fatty, or high-fiber foods and by... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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... Vomiting is the forceful expulsion of gastric contents through the mouth. Characteristically preceded by nausea, vomiting results from a coordinated sequence of abdominal muscle... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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... Detected by palpation, abdominal rigidity refers to abnormal muscle tension or inflexibility of the abdomen. Also known as abdominal muscle spasm or involuntary guarding, rigidity may... Emergency Actions ... History ... Physical assessment ... Medical causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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... Many diseasescause abdominal pain, and clinical dilemma is to distinguish life-threateningones from those that are mild and self-limited. Best way to approach diagnosis is toconsider age of child and whether pain is... Principal Causes of Acute Abdominal Pain ... Clinical Features and Diagnosis: Acute Abdominal Pain ... Diagnostic Approach: Acute Abdominal Pain ... Principal Causes of Chronic or Recurrent Abdominal Pain ... Diagnostic Approach: Chronic or Recurrent Abdominal Pain ... References
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...Although vomiting, abdominal pain, GI bleeding,hematuria, and fever accompany some types of abdominal mass lesions,other types occur without any associated signs and symptoms. Thus,it is especially important to examine the abdomen on each... Principal Causes of Abdominal Masses ... Clinical Features and Diagnosis ... Diagnostic Approach ... References
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...Regurgitation is the nonforceful expulsionof contents from esophagus or stomach, whereas vomiting is the forcefulexpulsion of gastric contents through the mouth. The first partof this chapter is concerned with regurgitation and... Principal Causes of Regurgitation ... Clinical Features and Diagnosis: Regurgitation ... Diagnostic Approach: Regurgitation ... Principal Causes of Vomiting ... Clinical Features and Diagnosis: Vomiting ... Diagnostic Approach: Vomiting ... References
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... Abdominal distention refers to increased abdominal girth—the result of increased intra-abdominal pressure forcing the abdominal wall outward. Distention may be mild or severe, depending on the amount of pressure. It may be... History and physical examination ... Medical causes ... Nursing considerations ... Patient teaching ... Pictures
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... Commonly detected on routine physical examination, an abdominal mass is a localized swelling in one abdominal quadrant. Typically, this sign develops insidiously and may represent an enlarged organ, a neoplasm, an abscess... History and physical examination ... Medical causes ... Nursing considerations ... Patient teaching ... Pictures
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... Abdominal pain usually results from a GI disorder, but it can be caused by a reproductive, genitourinary (GU), musculoskeletal, or vascular disorder; drug use; or ingestion of toxins. At times, such pain signals... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
... READ MEDICAL BOOK EXCERPTS ONLINE » (free access, no registration)
... Dyspepsia refers to an uncomfortable fullness after meals that's associated with nausea, belching, heartburn and, possibly, cramping and abdominal distention. Frequently aggravated by... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
... READ MEDICAL BOOK EXCERPTS ONLINE » (free access, no registration)
... Vomiting is the forceful expulsion of gastric contents through the mouth. Characteristically preceded by nausea, vomiting results from a coordinated sequence of abdominal muscle contractions and reverse... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
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... Detected by palpation, abdominal rigidity refers to abnormal muscle tension or inflexibility of the abdomen. Rigidity may be voluntary or involuntary. Voluntary rigidity reflects the patient's fear or nervousness upon palpation;... History and physical examination ... Medical causes ... Nursing considerations ... Patient teaching ... Pictures
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...
As the physician examines the abdomen, how can he or she recall all of
the causes of a mass or swelling? The physician should consider the
possibilities for the... Pictures
... READ MEDICAL BOOK EXCERPTS ONLINE » (free access, no registration)
...
These two should be considered together, because nausea is just a
forme fruste of vomiting. This symptom lends itself well to anatomic analysis,
particularly by... Pictures
... READ MEDICAL BOOK EXCERPTS ONLINE » (free access, no registration)
...
The GI tract is the only “organ” that really covers the abdomen
from one end to the other. Anything that causes an irritation of all or a
large portion of this &... Pictures
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... Marina Catallozzi
Approach to the Patient with Abdominal Pain
I. Definition of the Complaint
Abdominal pain is a common complaint ... Pictures
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... I. History of Present Illness
A 13-year-old boy presented with recurrent abdominal pain. He reported
intermittent right upper quadrant pain for the last year, which occurred two to
three times per ... Pictures
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... I. History of Present Illness
A 5-year-old girl was well until 2 days before presentation, when she developed
emesis and fever. On the day of presentation, ... Pictures
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... I. History of Present Illness
The patient, an 11-year-old girl, was well until 1 year before presentation,
when she was diagnosed with streptococcal pharyngitis. ... Pictures
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... I. History of Present Illness
A 9-year-old girl was well until 6 days before admission, when she developed
vomiting, abdominal pain, and lethargy. Four days before admission, ... Pictures
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... I. History of Present Illness
The patient, an 8-year-old boy, was well until 4 hours before presentation. At
that time, he ... Pictures
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... I. History of Present Illness
The patient, a 2-year-old girl, was well until 1 month before presentation, when
she began to experience intermittent periods of abdominal pain.
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... I. History of Present Illness
A 3-year-old girl of Sri Lankan descent who was born in the United States
presented to the emergency department with a fever of 40.5
°C for the past 2 days. ... Pictures
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... Author:
Michael Clemmens, MD
What to Do - Interpret the Data
Ovarian torsion is an uncommon condition with potentially serious complications. Torsion... Suggested Readings
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... Author:
Michael S. Potter and Anthony Slonim, MD
What to Do - Gather Appropriate Data
Teen pregnancy in the United States is disproportionately more frequent
than it is in other industrialized... Suggested Reading
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... Author:
Caroline Rassbach, MD
What to Do - Gather Appropriate Data
Testicular torsion and ectopic pregnancy present similarly to appendicitis,
and both have serious morbidity if not quickly... Suggested Readings
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... Kurt A. Brown, MD Abdominal Pain - BASICS Abdominal Pain - description A child’s complaint of abdominal pain can originate from gastrointestinal and non... Abdominal Pain - DIAGNOSIS ... Abdominal Pain - FOLLOW UP ... Abdominal Pain - bibliography ... Abdominal Pain - CODES
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