№ 13Differential Diagnostic Topics17 min read
Differential diagnosis of abdominal pain
1. Big picture
Abdominal pain is a symptom, not a diagnosis. The examiner wants you to decide quickly:
- Is this an acute abdomen requiring urgent surgery/intervention?
- Is the patient unstable or septic?
- Which quadrant/localization gives the best differential?
- Is the pain visceral, parietal/peritoneal, referred, vascular, metabolic, or extra-abdominal?
The dangerous diagnoses to exclude first are:
- Peritonitis / perforated viscus
- Bowel obstruction
- Mesenteric ischemia
- Ruptured abdominal aortic aneurysm
- Acute pancreatitis
- Acute cholangitis / cholecystitis
- Appendicitis
- Ectopic pregnancy
- **Ovarian/testicular to
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