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Possible Diagnoses
Pancreatitis
Acute pancreatitis
Nausea
Vomiting
Mild discomfort
Left upper quadrant pain
Alleviated in fetal position
Worsens with movement
Acute upper abdominal pain
Boring pain
Periumbilical pain
Relief on bending forward
Relieved by sitting up
Epigastric pain
Pain radiate to back
Signs of hypovolemia
Anorexia
Hypotension
Abdominal distention
Blue-red-purple of flanks
Clinical signs of hypocalcemia
Gradual pain
Cholecystitis
Acute cholecystitis
Sudden onset
Pain persisting beyond 5 hours
Prolonged biliary pain
Prolonged right upper quadrant pain
Epigastric pain
Acute onset of upper abdominal pain
Upper abdominal pain
Abdominal pain
Steady pain
More severe than biliary colic
Severe pain
Positive murphy sign
Right upper quadrant pain
Unremitting right upper quadrant pain
Fever
Nausea
Murphy's sign
Vomiting
Previous episode of biliary pain
Low grade fever
Emphysematous cholecystitis
Sudden onset
Pain persisting beyond 5 hours
Prolonged biliary pain
Prolonged right upper quadrant pain
Epigastric pain
Acute onset of upper abdominal pain
Left hypochondrial pain
Left upper quadrant pain
Midline upper abdominal pain
Right hypochondrial pain
Abdominal pain
Steady pain
More severe than biliary colic
Severe pain
Positive murphy sign
Right upper quadrant pain
Unremitting right upper quadrant pain
Fever
Nausea
Murphy's sign
Gastroparesis
Gastroparesis
Nausea
Upper abdominal pain
Easy satiety
Pain with sleeping
Mild bloating
Gastric residual in four hours
Vomiting
Exacerbate after eating
Bloating
Postprandial fullness
Weight loss
Epigastric pain
Postprandial nausea
Abdominal discomfort
Burning sensation
Crampy sensation
Epigastric distention
Epigastric tenderness
Gastric retention
Localized pain
Alcoholic liver disease
Alcoholic liver disease
Anorexia
Fatigue
Fever
Jaundice
Nausea
Right upper quadrant abdominal discomfort
Vomiting
Weight loss
Digital clubbing
Palmar erythema
Ascites
Splenomegaly
Asterixis
Confusion
Dupuytren contractures
Gynecomastia
Hematemesis
Leg swelling
Weight gain
Gastrointestinal bleeding
Biliary colic
Biliary colic
Plateauing within an hour
Acute
Dull discomfort
Steady fullness
Upper abdominal pain
Epigastric pain
Right upper quadrant pain
Subsides gradually over 30 minutes to several hours
Sudden onset pain
Constant pain
Intense pain
Recurrent attacks
Gnawing pain
Last at least 30 minutes
Episodes separate in months
Episodes separate in weeks
Diaphoresis
Restlessness
Deep pain
Hours to years frequency
Hepatitis
Alcoholic hepatitis
Right upper quadrant abdominal discomfort
Fails to correct prolonged prothrombin time with vitamin k
Liver is enlarged
Fever
Anorexia
Liver is tender
Asterixis
Gastrointestinal bleeding
Fatigue
Lack of stamina
Lethargy
Poor energy
Weakness
Cardiomyopathy
Pancreatic dysfunction
Skeletal muscle wasting
Abdominal distension
Abdominal wall collaterals
Bruit heard over liver
Cutaneous telangiectasias
Cirrhosis
Alcoholic liver cirrhosis
Ascites
Anorexia
Fatigue
Fever
High-grade fever
Increased need for sleep
Lack of stamina
Lethargy
Listlessness
Low-grade fever
Malaise
Nausea
Poor energy
Right upper quadrant abdominal discomfort
Vomiting
Weight loss
Cardiomyopathy
Pancreatic dysfunction
Skeletal muscle wasting
Abdominal wall collaterals
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
Gastroenteritis
Mucosal eosinophilic gastroenteritis
Diarrhea
Early satiety
Nausea
Vomiting
Abdominal bleeding
Acute onset of gastrointestinal bleeding
Black stool
Bleeding episodes
Blood in the vomitus
Colitis
Gi bleeding
Hemorrhagic complications
Melena
Occult blood
Stool guaiac-positive
Tarry stool
Bloody diarrhea
Discomfort or pain in upper belly
Discomfort or pain near the ribs
Upset stomach
Hereditary angioedema
Hereditary angioedema
Extremities skin swelling
Face skin swelling
Genitals skin swelling
Skin swelling
Exacerbating by oral contraceptives
Abdominal distension
Abdominal pain
Gastrointestinal colic
Nausea
Vomiting
Diarrhea
Exacerbating by stress
Skin sensation of fullness
Skin sensation of irritation
Skin tingling
Chicken-wire pattern of erythematous discoloration
Erythema marginatum
Erythematous discoloration
Exacerbating by bacteriuria
Exacerbating by bicycle riding
Acute fatty liver of pregnancy
Acute fatty liver of pregnancy
Nausea
Vomiting
In third trimester
Multiple gestations
Jaundice
Abdominal pain
Anorexia
Confusion
Edema
Epigastric pain
Hepatic encephalopathy
Hypertention
Lactic acidosis
Malaise
Signs of preeclampsia
Before delivery
Polydipsia
Dic
Infection
Long ptt
Nausea and Vomiting
History, PE, Laboratory evaluation
Assess for mechanical obstruction, peritonitis, dehydration, or bleeding
YES (mechanical obstruction, peritonitis, dehydration, or bleeding)
Replace fluids, Consider hospitalization
NO (mechanical obstruction, peritonitis, dehydration, or bleeding)
Regurgitation of undigested food? rumination, esophageal stricture, Zenker’s diverticulitis
Assess for pharmacologic or toxic causes
YES (pharmacologic or toxic causes)
Discontinue offending agent Treat toxicity
NO (pharmacologic or toxic causes)
Constant or recurrent, intermittent
Consider: Migraines, Seizure disorder, Cyclic vomiting, CNS lesions
Duration < 1 wk
Consider: Food poisoning, Gastroenteritis
Fluid and electrolyte replacement, observation, antiemetics
Duration > 7 days
Predominantly AM vomiting
Consider: Pregnancy, Uremia, Alcohol use, Increased intracranial pressure
Focal defects, Brainstem Posterior fossa, Abdominal migraine
Etiology still uncertain
Consider: Electrogastrography, MRI of brain
Vomiting > 1 hr after meal
Gastric emptying study
Prolonged emptying
Consider: Gastroparesis, Trial prokinetic agents, Gastric outlet obstructions
EGD
Normal emptying
Consider: Conversion reaction, Depression
Psychological evaluation
Vertigo
Consider: Labyrinthine disorder
Etiology still uncertain
Consider: Electrogastrography, MRI of brain
Vomiting immediately after meals
Consider: Gastroesophageal reflux disease, Bulimia
Etiology still uncertain
Consider: Electrogastrography, MRI of brain
Chronic orthostatic hypotension, hyponatremia
Consider: Adrenal insufficiency
Etiology still uncertain
Consider: Electrogastrography, MRI of brain
Weight loss
Consider: Malignancy, Gastroparesis, Gastric outlet obstruction
EGD
Etiology still uncertain
Consider: Electrogastrography, MRI of brain