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Primary Care Diagnosis of Acute Abdominal Pain

The Nurse Practitioner: December 1996

ABSTRACTThe abdomen, as the largest cavity in the body, holds both fixed as well as relatively mobile organs, which when either diseased, traumatized, malfunctioning, or infected may present a wide and diverse range of signs and symptoms. Clues to the origin of abdominal pain can be well-localized or referred and quite obtuse.This article reviews the surface anatomy of the abdomen, the ??ypes of abdominal pain, approach ?? the patient with abdominal pain, ??nd history-taking and physical examination. Adjunctive studies, ??hich might help to reduce the differential diagnosis, are mentioned.The goal of this article is to help the reader formulate an accurate ??iagnosis in a timely manner via a complete but also well-focused physical examination; attention is ??paid to a comprehensive differential diagnosis to include common and not so common causes of ??cute abdominal pain. Intra-abdominal sources of abdominal pain include: peritonitis, bowel obstruc?? ??on, and vascular disorders. Extra?? ?? abdominal sources of abdominal ??in include the thorax, pelvis, and the abdominal wall. Some metabolic and neurogenic sources of ??bdominal pain are examined. Life?? ??threatening causes of abdominal pain include ectopic pregnancy, acute myocardial infarction, abdominal aortic aneurysm, splenic ??pture, and obstructed bowel. Discussion of these entities concen??ates on the initial presentation of ??he patient, typical progression of ??symptoms, and appropriate initial ??reatment as well as referral. The ??ocess of ruling out emergent ab?? ?? dominal pain is also examined.

© Williams & Wilkins 1996. All Rights Reserved.