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DDxPro
Possible Diagnoses
Peptic ulcer
Duodenal ulcer
Awakes from sleep
Relief with anti secretory agents
Recurs several hours after a meal
Recurs when stomach is empty
When stomach is empty
Burning pain
Upper abdomen discomfort
At night
Epigastric pain
Hunger-like pain
Relieved by eating
Relief with antiacid
Awakes the patient from sleep
Vomiting after eating
Radiate to back
Meal related
Epigastric tenderness
Nausea relieved by eating
Severe abdominal pain
Discomfort or pain in upper belly
Gastric ulcer
Awakes from sleep
Relief with anti secretory agents
Recurs when stomach is empty
When stomach is empty
Burning pain
Upper abdomen discomfort
At night
Epigastric pain
Hunger-like pain
Relieved by eating
Relief with antiacid
Awakes the patient from sleep
Discomfort or pain in upper belly
Discomfort or pain near the ribs
Upset stomach
three months
Diarrhea
Burning
Symptom onset at least six months
Abdominal pain
Peptic ulcer
Centered in epigastrium
Epigastric pain
Awakes the patient from sleep
Relief with anti secretory agents
Recurs when stomach is empty
Burning pain
Upper abdomen discomfort
At night
Relieved by eating
Relief with antiacid
Gnawing pain
Worsens with eating
Dyspepsia
Patient show site of pain with one finger
Vomiting after eating
Radiate to back
Meal related
Recurrent abdominal pain
Weight loss
Anorexia
Acute peptic ulcer
Awakes from sleep
Relief with anti secretory agents
Abdominal pain
Intense pain
More localized pain
Recurs when stomach is empty
Sudden onset
When stomach is empty
Burning pain
Upper abdomen discomfort
At night
Epigastric pain
Hunger-like pain
Sudden severe abdominal pain
Relieved by eating
Relief with antiacid
Awakes the patient from sleep
Hematochezia
Vomiting
Diffused
Pancreatic cancer
Pancreatic cancer
Asthenia
Weight loss
Anorexia
Abdominal pain
Intermittent pain
Epigastric pain
Jaundice
Intermittent abdominal pain
New onset of diabetes mellitus
Nausea
Midepigastric pain
Upper abdominal pain
Radiate to back
Radiate to sides
Hepatomegaly
Vomiting
Courvoisier sign
Trousseau syndrome
Palpable periumbilical mass
Abdominal mass
Pancreatic sod
Pancreatic sod
Recurrent right upper quadrant pain
at least 30 minutes
Epigastric pain
Exclusion of other structural disease explain symptoms
Moderate pain
Pain builds up to a steady level
Pain interrupt patients daily activities
Pain lead to an emergency department visit
Pain not relieved by antiacids
Pain not relieved by bowel movements
Pain not relieved by postural change
Recurrent symptoms occurring at different intervals not daily
Right upper quadrant pain
Severe pain
Nausea
Pain awakening patient from sleep in middle of night
Pain radiating to back
Pain radiating to infrascapular region
Vomiting
Occurs months apart
Biliary sod
Biliary sod
Presence of both elevated liver enzymes and a dilated cbd
Recurrent pain
Recurrent right upper quadrant pain
Epigastric pain
Last at least 30 minutes
Right upper quadrant pain
Exclusion of other structural disease explain symptoms
Moderate pain
Pain builds up to a steady level
Pain interrupt patients daily activities
Pain lead to an emergency department visit
Pain not relieved by antiacids
Pain not relieved by bowel movements
Pain not relieved by postural change
Recurrent symptoms occurring at different intervals not daily
Severe pain
Biliary type pain
Nausea
Pain awakening patient from sleep in middle of night
Pain radiating to back
Crohn disease
Crohn disease
Abdominal tenderness
Perianal skin tag
Sinus tracts
Abdominal pain
Diarrhea
Abdominal mass
Recurrence after surgery
Response to antibiotics
Prolonged diarrhea
Chronic diarrhea
Tender mass is palpable
Fever
Fatigue
Weight loss
Episodes of colonic obstruction
Episodes of small bowel obstruction
Frequently right lower quadrant pain
Crampy abdominal pain
Right lower quadrant mass
Pain relieved by defecation
Irritable bowel syndrome
Irritable bowel syndrome
Change in bowel habit
Constipation alternating with diarrhea
Change in stool appearance
Change in stool form
Abdominal pain
Chronic abdominal pain
Abdominal bloating
Abnormal stool frequency
Change in form (appearance) of stool
Change in form or consistency of stool at onset of pain
Fecal urgency
Feeling of incomplete evacuation
Looser stools at onset of pain
More frequent stools at onset of pain
Mucus discharge with stools
Occur once a week
Recurrent abdominal discomfort
Recurrent abdominal pain
Recurrent abdominal pain or discomfort
Relieved by defecation
Zollinger-ellison syndrome
Zollinger-ellison syndrome
Develop peptic ulcers
Abdominal pain
Peptic ulcer associated with endocrinopathy
Peptic ulcer refractory to treatment or persistent
Sporadic gastrinomas
Ulcers presenting with frank complications
Diarrhea
Steatorrhea
Associated with gastroesophageal reflux disease
Gastrointestinal bleeding
Associated with duodenal ulcer
Mild esophagitis
Chronic unexplained diarrhea
Ulcers in absence of nsaid ingestion
Perforation
Recurrent severe multiple peptic ulcers
Accelerate transit
Multiple recurrent complicated duodenal ulcers
Refractory diarrhea
Severe diarrhea
Chronic bacterial prostatitis
Chronic bacterial prostatitis
Bulk-related symptoms
Charcot triad
Constitutional symptoms
Cystitis
Cystitis symptoms
Fever
High grade fever
High-grade fever
Intermittent fever
Low grade fever
Mild fever
Pelvic pain
Perineal pain
Recurrent abdominal pain
Recurrent infection
Recurrent pain
Recurrent uti
Reynold pentad
Suprapubic pain
Symptoms onset six months
Choledochal cyst
Choledochal cyst
Abrupt onset abdominal pain
Acute abdominal pain
Cramping abdominal pain
Diffuse abdominal pain
Frank abdominal pain
Gastrointestinal colic
Gi disturbance
Left sided abdominal pain
Lower abdominal pain
Mid-abdominal pain
Periumbilical pain
Postprandial abdominal pain
Progressive abdominal pain
Recurrent abdominal pain
Right sided abdominal pain
Upper abdominal pain
Relieved by sitting up
Abdominal mass
Biliary lithiasis
Gradual
Acute Abdominal Pain
History and physical examination
Unstable or Obvious surgical indication
Consider: Hemorrhage Perforation Acute peritonitis Bowel obstruction Ischemia
Resuscitation
Surgical consultation
LAPAROTOMY
Stable
Observation
Exclude: Medical causes
Consider: Inadequate physical manifestations
Further studies
Decreased pain
Observation
Continued pain Increased pain
Surgical Consultation
Chronic Abdominal Pain
History Physical examination, Laboratory tests
Evidence suggestive of visceral organ source
Stomach
Consider: Peptic ulcer Gastric tumor
Endoscopy Upper GI Series
Small bowel
Consider: Inflammation Tumor Obstruction
Small Bowel Follow-Through or Enteroclysis CT
Pancreas
Consider: Pancreatitis Cyst/tumor
Ultrasonography CT ERCP Pancreatic Function Test
Hepatobiliary
Consider: Gallstones Biliary obstruction Tumor/cyst Infiltration Chronic hepatitis Engorgement
Ultrasonography CT ERCP Liver Biopsy
Renal
Consider: Pyelonephritis Nephrolithiasis Tumor/cyst
Ultrasonography CT IV Pyelography
Colon
Consider: Inflammation Tumor Obstruction Diverticulosis
Barium Enema and/or Endoscopy
Abdominal wall source
Referred spinal nerve source
Vascular aneurysm
Ultrasonography CT Angiography
Pelvic source
Ultrasonography Laparoscopy
Nonlocalized or inapparent source
Consider: Metabolic disorders
Functional pain/dysmotility
IBS Nonulcer dyspepsia Postcholecystectomy syndrome
Chronic mesenteric ischemia Vasculitis
Angiography
Consider: Drug effect Lead toxicity
Consider: Tumor/cyst Infection Inflammatory process: Peritoneum Mesentery Omentum Retroperitoneum
Ultrasonography CT Laparoscopy Laparotomy