Abdominal Pain in the Central Abdomen

CLINICAL DIAGNOSTIC MANUAL

Abdominal pain in the central abdomen, including the epigastric, periumbilical, and hypogastric regions, can be a symptom of various conditions affecting internal organs such as the stomach, pancreas, small intestine, colon, and bladder.

This pain can present acutely or chronically, and its characterisation is essential for guiding appropriate diagnosis and management. Pain in this region may indicate benign conditions or more serious pathologies that require immediate medical attention.

Pathology	Symptoms and Clinical Signs	Suspicion Diagnosis	Confirmatory Diagnosis
Gastritis	Epigastric pain, nausea, vomiting, abdominal distension	Clinical history, physical examination	Upper gastrointestinal endoscopy, gastric biopsy
Peptic Ulcer	Epigastric pain relieved by eating, hematemesis or melena	Clinical history, physical examination, complete blood count	Upper gastrointestinal endoscopy, Helicobacter pylori test
Acute Pancreatitis	Severe epigastric pain radiating to the back, nausea, vomiting, fever	Clinical history, physical examination, blood biochemistry	Abdominal CT scan, serum amylase and lipase levels
Acute Appendicitis	Periumbilical pain shifting to the right lower quadrant, fever, nausea, vomiting	Clinical history, physical examination, complete blood count	Abdominal CT scan, abdominal ultrasound
Intestinal Obstruction	Central abdominal pain, distension, absence of gas and stool passage, vomiting	Clinical history, physical examination, abdominal X-ray	Abdominal CT scan, abdominal X-ray
Gastroenteritis	Diffuse abdominal pain, diarrhoea, nausea, vomiting, fever	Clinical history, physical examination, stool analysis	Stool analysis, stool culture
Diverticulitis	Left lower quadrant pain, fever, nausea, changes in bowel habits	Clinical history, physical examination, complete blood count	Abdominal CT scan, colonoscopy
Cystitis	Hypogastric pain, dysuria, urinary urgency, haematuria	Clinical history, physical examination, urinalysis	Urine culture
Endometriosis	Chronic pelvic pain, dysmenorrhoea, dyspareunia	Clinical history, gynaecological examination	Laparoscopy
Inflammatory Bowel Disease	Chronic abdominal pain, bloody diarrhoea, weight loss, fatigue, fever	Clinical history, physical examination, complete blood count, stool analysis	Colonoscopy, intestinal biopsy, abdominal CT scan