Abdominal pain: Difference between revisions

3,151 bytes added ,  1 year ago
** kidney pain ([[kidney stone]], [[kidney cancer]], [[hydronephrosis]])
** [[Ureter#Ureteral stones|Ureteral stone]] pain
==Diagnostic approach==
In order to better understand the underlying cause of abdominal pain, one can perform a thorough history and physical examination.
The process of gathering a history may include:<ref name=":1">{{Cite book|title=Bates' Guide to Physical Examination & History Taking|last=Bickley|first=Lynn|publisher=Lippincott Williams & Wilkins|year=2016|isbn=9781469893419|location=Philadelphia, Pennsylvania|pages=}}</ref>
* Identifying more information about the [[Presenting problem|chief complaint]] by eliciting a [[History of the present illness|history of present illness]]; i.e. a narrative of the current symptoms such as the onset, location, duration, character, aggravating or relieving factors, and temporal nature of the pain. Identifying other possible factors may aid in the diagnosis of the underlying cause of abdominal pain, such as recent travel, recent contact with other ill individuals, and for females, a thorough [[Gynaecology|gynecologic]] history.
* Learning about the patient's past medical history, focusing on any prior issues or surgical procedures.
* Clarifying the patient's current medication regimen, including prescriptions, over-the-counter medications, and supplements.
* Confirming the patient's drug and food allergies.
* Discussing with the patient any family history of disease processes, focusing on conditions that might resemble the patient's current presentation.
* Discussing with the patient any health-related behaviors (e.g. tobacco use, alcohol consumption, drug use, and sexual activity) that might make certain diagnoses more likely.
* Reviewing the presence of non-abdominal symptoms (e.g., [[fever]], chills, [[chest pain]], [[shortness of breath]], [[vaginal bleeding]]) that can further clarify the diagnostic picture.
After gathering a thorough history, one should perform a [[Physical examination|physical exam]] in order to identify important physical signs that might clarify the diagnosis, including a [[Cardiovascular examination|cardiovascular exam]], lung exam, thorough abdominal exam, and for females, a [[Genitourinary system|genitourinary]] exam.<ref name=":1" />
Additional investigations that can aid diagnosis include:<ref name=":2">{{Cite journal|last=Cartwright|first=Sarah L.|last2=Knudson|first2=Mark P.|date=2008-04-01|title=Evaluation of Acute Abdominal Pain in Adults|url=http://www.aafp.org/afp/2008/0401/p971.html|journal=American Family Physician|language=en|volume=77|issue=7|issn=0002-838X}}</ref>
* Blood tests including [[complete blood count]], [[basic metabolic panel]], [[Electrolyte|electrolytes]], [[liver function tests]], [[amylase]], [[lipase]], [[troponin I]], and for females, a serum [[pregnancy test]].
* [[Urinalysis]]
* Imaging including chest and abdominal [[X-ray|X-rays]]
* [[electrocardiograph|Electrocardiogram]]
If diagnosis remains unclear after history, examination, and basic investigations as above, then more advanced investigations may reveal a diagnosis. Such tests include:<ref name=":2" />
* [[Computed tomography]] of the abdomen/pelvis
* Abdominal or pelvic [[ultrasound]]
* [[Endoscopy]] and/or [[colonoscopy]]