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DDxPro
Possible Diagnoses
Sigmoid volvulus
Sigmoid volvulus
Abdominal pain
Tenderness
Abdominal distension
Obstipation
Constipation
Nausea
Colicky pain
Continuous pain
Severe pain
Tympanitic abdomen
Recurrent pain
Vomiting
Lead to gangrene
Peritonitis
Sepsis
Acute appendicitis
Acute appendicitis
Abdominal tenderness
Onset of abdominal pain
Right lower quadrant tenderness
Shift to the left
Anorexia
Mild vomiting
Nausea
Vague discomfort
Vague pain
More localized to right lower quadrant pain after several hours
Vague periumbilical pain
Migratory right iliac fossa pain
Pain migration from periumbilical to right lower quadrant
Mcburneys point tenderness
Sharper pain
Positive alvarado score
Rebound tenderness
Rebound tenderness in the right iliac fossa
Tenderness in the right iliac fossa
Fever
Psoas abscess
Psoas abscess
Flank pain
Lower abdominal pain
Lower back pain
Psoas sign
Fever
Pain referred to the hip
Pain referred to the knee
Radiate to anterior thigh
Radiate to buttocks
Radiate to posterior thigh
Limitation of hip movement
Subacute
Absence of pain in the retrovesical pouch
Anorexia
Anterior thigh muscles weakness
Buttocks weakness
Diabetes
Hiv infection
Inguinal mass
Instrumentation in the hip region
Acute intermittent porphyria
Acute intermittent porphyria
Abdominal pain
Severe abdominal pain
Severe pain
Tachycardia
Back pain
Poorly localized pain
Steady pain
Vomiting
Constipation
Chest pain
Head pain
Limb pain
Muscle weakness
Neck pain
Nausea
Psychiatric symptoms
Hypertension
Dysuria
Urinary retention
Sensory loss
Adrenal crisis
Adrenal crisis
Shock
Abdominal pain
Back pain
Flank pain
Lower chest pain
Weakness
Meningococcemia
Circulatory failure
Hypovolemic shock
Vasodilatory shock
Fever
Primary adrenal insufficiency
Generalized tenderness
Fatigue
Lethargy
Anticoagulant
Antiphospholipid syndrome
Coagulopathy
Cytomegalovirus infection
Dehydration
Pyelonephritis
Acute pyelonephritis in adults
Back pain
Costovertebral angle tenderness
Flank pain
Chills
Fever
Enlarging uterus
Hormonal changes
Dehydration
Nausea
Vomit
Autonomic dysreflexia
Change in functional status
Change in mental status
Chemotherapy
Corticosteroid
Delirium
Fall
Frequent sexual intercourse
Having new sex partner
Health care exposures
Shigellosis
Shigellosis
Abdominal cramps
Abdominal pain
Mucoid diarrhea
Mucopurulent diarrhea
Anorexia
August
July
June
October
September
Frequent small volume stools
Tenesmus
Bloody diarrhea
High fever
Diarrhea
Features of hemolytic uremic syndrome
Fever
Severe illness with dysentery
Generalized seizures
Seizures
Peritonitis
Peritoneal dialysis associated peritonitis
Cloudy peritoneal effluent
Abdominal pain
Peritoneal signs
Systemic signs
Abdominal tenderness
Diarrhea
Gastrointestinal complaints
Cloudy dialysate
Diffuse pain
Fever
Nausea
Vomiting
Rebound tenderness
Mildly elevated peritoneal fluid amylase
Stool in the dialysate
Severe abdominal pain
Severe pain
Hypotension
Guarding
Toxic megacolon
Toxic megacolon
Frequently severe bloody diarrhea
Malaise
Abdominal distention
Abdominal pain
Altered sensorium
Hypotension
Mental status changes
Volume depletion
Fever
Tachycardia
Abdominal tenderness
Acute diarrhea
Postural hypotension
Appear very ill
Chronic diarrhea
Generalized peritonitis
Localized peritonitis
Lower abdominal distension
Lower abdominal tenderness
Toxic appearing patient
Pancreatitis
Chronic pancreatitis
Abdominal pain
Epigastric pain
Relieved by sitting up
Pain radiate to back
Weight loss
Nausea
Jaundice
Aching
Worse 15 to 30 minutes after eating
Back pain
Chronic diarrhea
Clusters of severe pain
Diabetes mellitus
Fatigue
Maldigestion
Mild pain
Moderate pain
Pain lasts several days
Pain to left of abdominal midline
Paralytic ileus
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
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
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