{"id":1541,"date":"2017-07-27T06:36:53","date_gmt":"2017-07-27T06:36:53","guid":{"rendered":"http:\/\/papergp.com\/index.php\/gi\/acute-abdominal-pain\/"},"modified":"2023-01-24T11:25:25","modified_gmt":"2023-01-24T11:25:25","slug":"acute-abdominal-pain","status":"publish","type":"page","link":"https:\/\/papergp.com\/index.php\/gi\/acute-abdominal-pain\/","title":{"rendered":"Acute abdominal pain"},"content":{"rendered":"<div class=\"content-box-blue\">\n<h4><strong>Data gathering<\/strong><\/h4>\n<ul>\n<li>History\n<ul>\n<li>SOCRATES &#8211; review differentials below depending on site<\/li>\n<li>Urinary &#8211; dysuria, frequency<\/li>\n<li>GI &#8211; bowel habit, flatus, vomiting, melaena<\/li>\n<li>Systemic &#8211; weight loss, E+D, fevers<\/li>\n<li>Gynae &#8211; LMP, PV discharge, PMB, PCB<\/li>\n<li>Cardiac &#8211; risk factors, epigastric<\/li>\n<li>PMH &#8211; previous abdominal surgery<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li>Examine\n<ul>\n<li>Obs &#8211; pulse, BP, temperature, RR, sats<\/li>\n<li>Abdomen (inspect, palpate, percuss, auscultate)<\/li>\n<li>PR<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/div>\n<hr \/>\n<div class=\"content-box-blue\">\n<h4><strong>Clinical management<\/strong><\/h4>\n<ul>\n<li>Investigations\n<ul>\n<li>Urine\n<ul>\n<li>Dipstick, MSU<\/li>\n<li>Pregnancy test<\/li>\n<\/ul>\n<\/li>\n<li>Bedside glucose measurement<\/li>\n<li>Bloods\n<ul>\n<li>FBC, U+E, LFTs, ESR, CRP<\/li>\n<\/ul>\n<\/li>\n<li>Stool\n<ul>\n<li>MC&amp;S, OCP<\/li>\n<li>H.pylori antigen<\/li>\n<\/ul>\n<\/li>\n<li>Imaging\n<ul>\n<li>CXR<\/li>\n<li>USS Abdomen<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li>Treatment\n<ul>\n<li>If referring, consider keeping patient nil by mouth<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<hr \/>\n<\/div>\n<div class=\"content-box-blue\">\n<h4><strong>Differential diagnosis<\/strong><\/h4>\n<ul>\n<li>RUQ\n<ul>\n<li>Gallbladder &#8211; Acute cholecystitis, Biliary colic<\/li>\n<li>Liver &#8211; Acute hepatitis,\u00a0Congestive hepatomegaly<\/li>\n<li>GI &#8211; Gastric ulcer<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li>Epigastric\n<ul>\n<li>Heart &#8211; MI<\/li>\n<li>GI &#8211; Gastric ulcer<\/li>\n<li>Pancreas &#8211; Acute pancreatitis<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/div>\n<div class=\"content-box-blue\">\n<ul>\n<li>LUQ\n<ul>\n<li>Spleen &#8211; Rupture<\/li>\n<li>GI &#8211; Gastric ulcer<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li>Lower abdomen\n<ul>\n<li>GI &#8211; Appendicitis (RLQ), Diverticulitis (LLQ), IBD<\/li>\n<li>Gynae &#8211; Ruptured ectopic, PID,\u00a0Ovarian torsion<\/li>\n<li>Urology &#8211;\u00a0UTI, Pyelonephritis, Testicular torsion<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li>Generalised\n<ul>\n<li>Intestinal obstruction &#8211; absolute constipation, vomiting, previous bowel surgery, absent bowel sounds<\/li>\n<li>Incarcerated hernias &#8211; painful enlargement of previously reducible hernia +- bowel obstruction<\/li>\n<li>Volvulus &#8211; bilious (yellow\/green) vomiting, cyclical vomiting, recurrent abdominal pain<\/li>\n<li>Perforation<\/li>\n<li>Meckel&#8217;s diverticulum &#8211; painless PR bleeding, can have symptoms of obstruction, can mimic appendicitis<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li>Medical causes\n<ul>\n<li>Pneumonia<\/li>\n<li>Diabetic Ketoacidosis or HONK &#8211; BM &gt; 15, ketones, polyuria, polydipsia<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li>Vascular\n<ul>\n<li>Acute intestinal ischaemia<\/li>\n<li>Abdominal aortic aneurysm<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li>More common in children\n<ul>\n<li>Constipation &#8211; mainly left sided\/suprapubic<\/li>\n<li>Gastroenteritis<\/li>\n<li>Intussusception &#8211; mostly &lt; 2 years old, paroxysms of colicky abdominal pain, vomiting, sausage shaped mass, red currant jelly stool<\/li>\n<li>Mesenteric adenitis &#8211; fever, \u00a0fluctuating severity of RLQ pain, URTI, Generally occurs age 5-10 years, no peritonism, child may be hungry. Far more common than appendicitis.<\/li>\n<li>Henoch Schonlein Purpura &#8211;\u00a0Diffuse \/ colicky abdominal pain, non-blanching rash, swollen ankles\/ knees, haematuria\/ proteinuria<\/li>\n<li>HUS &#8211; Unwell child with bloody diarrhoea and triad of: anaemia, thrombocytopenia &amp; renal failure<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li>Gynae\n<ul>\n<li>Mittelschmerz &#8211; one sided, sharp, usually lasts a few hours, in the middle of cycle (ovulation)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Data gathering History SOCRATES &#8211; review differentials below depending on site Urinary &#8211; dysuria, frequency GI &#8211; bowel habit, flatus, vomiting, melaena Systemic &#8211; weight loss, E+D, fevers Gynae &#8211; LMP, PV discharge, PMB, PCB Cardiac &#8211; risk factors, epigastric PMH &#8211; previous abdominal surgery Examine Obs &#8211; pulse, BP, temperature, RR, sats Abdomen (inspect, &hellip; <a href=\"https:\/\/papergp.com\/index.php\/gi\/acute-abdominal-pain\/\" class=\"more-link\">Continue reading <span class=\"screen-reader-text\">Acute abdominal pain<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"parent":315,"menu_order":63,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-1541","page","type-page","status-publish","hentry"],"jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/1541","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/comments?post=1541"}],"version-history":[{"count":10,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/1541\/revisions"}],"predecessor-version":[{"id":2521,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/1541\/revisions\/2521"}],"up":[{"embeddable":true,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/315"}],"wp:attachment":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/media?parent=1541"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}