top of page

Abdominal Pain

Writer's picture: Dr Fernando HidalgoDr Fernando Hidalgo
Oct 23, 20242 min read

Abdominal pain is a frequent and complex complaint encountered in the emergency department (ED), requiring careful evaluation to determine its cause and urgency. Here's an overview tailored for a junior doctor in emergency medicine:

Common Causes of Abdominal Pain

Abdominal pain can arise from various conditions, ranging from benign to life-threatening. Some of the most common causes include:

  • Gastrointestinal Issues: 

    • Gastroesophageal reflux disease (GERD)

    • Peptic ulcer disease

    • Gastritis

    • Bowel obstruction

    • Appendicitis, which is the most common cause of abdominal surgical emergencies[2][4][7].

  • Inflammatory Conditions:

    • Pancreatitis

    • Hepatitis

    • Colitis

    • Diverticulitis

  • Urological and Gynecological Causes:

    • Renal colic, often presenting with flank pain that radiates to the abdomen

    • Ectopic pregnancy, ovarian torsion, and pelvic inflammatory disease in women[1][2].

Evaluation and Diagnosis

History and Physical Examination

  • History: Gather detailed information about the onset, location, duration, and character of the pain. Note any associated symptoms like nausea, vomiting, fever, or changes in bowel habits[4][8].

  • Physical Examination: Assess for tenderness, guarding, or rebound tenderness which may suggest peritonitis. Vital signs are crucial; abnormalities can indicate serious underlying conditions[8].

Diagnostic Tools

  • Laboratory Tests: Complete blood count, liver function tests, lipase/amylase for pancreatitis, and urinalysis.

  • Imaging: Ultrasound is useful for gallbladder or gynecological issues. CT scans are often used for more detailed evaluation and are particularly valuable in diagnosing appendicitis or bowel obstructions[6][7].

Management in the Emergency Department

Pain Management

  • Administering analgesia is important for patient comfort and does not typically obscure diagnosis. Opioids can be used judiciously but should be balanced with ongoing assessment to avoid masking symptoms of acute surgical conditions[3][5].

Risk Stratification and Disposition

  • High-Risk Patients: Identify those who may require immediate surgical intervention or further inpatient evaluation. This includes patients with signs of peritonitis, unstable vital signs, or those suspected of having conditions like appendicitis or bowel obstruction[6].

  • Observation and Follow-Up: For non-critical cases, consider observation or outpatient follow-up if symptoms persist or worsen[8].

Understanding the broad spectrum of potential causes and employing a systematic approach to evaluation can help ensure effective management of abdominal pain in the emergency setting.

15 views0 comments

Comments

Rated 0 out of 5 stars.
No ratings yet
Add a rating
bottom of page