Evaluation and management of acute abdominal pain in the emergency department

Christopher R Macaluso, Robert M McNamara
International Journal of General Medicine 2012, 5: 789-97
Evaluation of the emergency department patient with acute abdominal pain is sometimes difficult. Various factors can obscure the presentation, delaying or preventing the correct diagnosis, with subsequent adverse patient outcomes. Clinicians must consider multiple diagnoses, especially those life-threatening conditions that require timely intervention to limit morbidity and mortality. This article will review general information on abdominal pain and discuss the clinical approach by review of the history and the physical examination. Additionally, this article will discuss the approach to unstable patients with abdominal pain.

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Phillip Sirota

1. Understand the difference between visceral pain and somatic pain and how the embryologic origin of the tissue involved helps to predict where visceral pain is felt.
2. Know the patterns of pain radiation in referred pain.
3. Is analgesia contraindicated in the patient with abdominal pain because of the concern of obscuring the diagnosis?
4. Know the diagnostic imaging tests for a patient with acute abdominal pain and their sensitivities and specificities for a surgical emergency.


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