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DDxPro
Possible Diagnoses
Peritonitis
Spontaneous bacterial peritonitis
Acute onset of symptoms
Exacerbation of preexisting hepatic encephalopathy
Fever
Diffuse pain
Diffuse abdominal pain
Altered mental status
Abdominal tenderness
Nausea
Vomiting
Diarrhea
Hypotension
Hypothermia
Gastrointestinal bleeding
Strict immobility
Peritoneal irritation
Minimize abdominal pain by supine position with knees flexed
Minimize abdominal pain by supine with knees flexed
Pain aggravate by motion
Worsening renal function
Complete lack of bowel sounds
Amebiasis
Intestinal entamoeba histolytica amebiasis
Bloody diarrhea
Bloody stools
Diarrhea
Mild diarrhea
Several weeks diarrhea
Watery diarrhea
Exposure in endemic area
Abdominal pain
Lower abdominal pain
Amebic dysentery
Back pain
Diarrhea with blood in stools
Environmental enteropathy
Hematophagous trophozoites
Impoverished gut
Malaise
Weight loss
Fever
Colitis
Malnutrition
Gastroenteritis
Viral gastroenteritis
Non bloody diarrhea
Watery diarrhea
Acute onset of vomiting
Acute onset of diarrhea
Diarrhea
Vomiting
Anorexia
Malaise
Fever
Nausea
Signs of volume depletion
Colicky pain
Pain is less marked
Cramping pain
Dry mucous membranes
Hypotension
Tenesmus
Abdominal cramps
Abdominal tenderness
Blood in stool
Listerial gastroenteritis
Signs of volume depletion
Abdominal pain
Decreased skin turgor
Reduced skin turgor
Diarrhea
Dry mucous membranes
Watery diarrhea
Bloody diarrhea
Last less than two days
Travel
Continuous pain
Radiates to right iliac fossa
Colicky pain
Constitutional symptoms
Drinking unclean well or surface water
Drinking unpasteurized milk
Ingesting ground beef
Pain is less marked
Cramping pain
Fever
Salmonella infection
Salmonella infection
Pea soup
Watery diarrhea
Weight loss
Diarrhea
Abdominal symptoms
Enteric fever
Fever
Foodborne disease
Gastroenteritis
Poultry dairy items
Raw milk
Reptile exposure
Sickle cell disease
Undercooked eggs
Fatigue
Malaise
Chills
Headaches
Decreased skin turgor
Dry mucus membranes
Liver abscess
Amebic liver abscess
Abdominal pain
Fever
Last less than 14 days
Right upper quadrant tenderness
Hepatomegaly
Weight loss
Pleuritic pain
Jaundice
Cough
Severe pain
Right upper quadrant pain
Acute onset
Solitary lesion
days
weeks
Fevers
Last days
Last one to two weeks
One to two weeks of fever
One to two weeks of right upper quadrant pain
Klebsiella pneumoniae liver abscess
Fever
Right upper quadrant tenderness
Fatigue
Lack of stamina
Lethargy
Poor energy
Weakness
Chills
Abdominal pain
Nausea
Vomiting
Severe pain
Thrombophlebitis
Punch tenderness
Rebound tenderness
Hepatomegaly
Jaundice
Solitary lesion
Localized to right upper quadrant
5 to 26 days
Pyogenic liver abscess
Fever
Fatigue
Abdominal pain
Hepatomegaly
Jaundice
Chills
Nausea
Vomiting
Right upper quadrant tenderness
Pleuritic pain
Shortness of breath
Weight loss
Cough
Severe pain
Right upper quadrant guarding
Right upper quadrant pain
Right upper quadrant rocking tenderness
Punch tenderness
Rebound tenderness
Last 5 to 26 days
Rocky mountain spotted fever
Rocky mountain spotted fever
Fever
Blanching erythematous rash
Maculopapular rash
Skin rash
Headache
Nausea
Vomiting
Rash on the palms
Tick bite
Anorexia
Early summer
Malaise
Myalgia
Severe headache
Triad of fever rash and tick exposure
Petechiae
Triad of fever rash and headache
Petechia not disappear upon compression
Petechial rash
Maculopapular rash on the ankles
Brucellosis
Brucellosis
Lethargy
Sweating
Weight loss
Arthralgia
Chills
Fever
Acute febrile illness
Night sweats
Joint swelling
Joint tenderness
Arthlargia
Arthlargia of hips
Arthlargia of knees
Arthlargia of spine
Malaise
Joint bursitis
Intermittent back pain
Pallor
Conjuctival contact with infected brucella material
Inhalation of infected aerosols
Kawasaki disease
Kawasaki disease
Bilateral conjunctivitis
Conjunctivitis
Nonexudative conjunctivitis
Cutaneous desquamation
Periungual desquamation
Anterior uveitis
Oral cavity erythema
Red lips
Fever
Fever more than 5 days
Strawberry tongue
Cervical lymphadenopathy
Mucositis
Abdominal pain
Diarrhea
High-grade fever
Prolonged fever
Arthralgia
Asian ethnic group
Cracked lips
Travelers diarrhea
Travelers diarrhea
Watery diarrhea
Abdominal cramps
Abdominal discomfort
Fecal urgency
Dehydration
Colitis
Anorexia
Belching
Blind loop syndrome
Bloating
Cimetidine
Famotidine
Malaise
Prior ulcer surgery
Ranitidine
Taking histamine blocker
Unable to proceed with planned activities
Bloody diarrhea
Fever
Tenesmus
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