General Surgery/GIT _ Abdominal Pain Flashcards
DDX for RUQ pain
- Biliary disease
- colitis
- hepatic abscess or mass
- pulmonary infection or embolus
- renal stone or infection
- pelvic inflammatory disease with liver capsule inflammation (Fitz-Hugh-Curtis Syndrome)
Epigastric pain DDX
- Myocardial infarction (MI) or pericarditis
- biliary disease
- esophagitis
- gastritis or peptic ulcer
- pancreatic mass or pancreatitis
- aortic dissection
- mesenteric ischemia
RLQ Pain DDX
- Appendicitis
- colitis
- irritable bowel syndrome/inflammatory bowel disease (IBS/IBD) or diverticulitis
- ectopic pregnancy
- fibroids
- ovarian mass
- ovarian torsion
- pelvic inflammatory disease (PID)
- nephrolithiasis or pyelonephritis
- hernia
LLQ pain DDX
- Diverticulitis
- colitis
- or sigmoid volvulus
- ectopic pregnancy
- fibroids
- ovarian mass
- ovarian torsion
- PID
- nephrolithiasis or pyelonephritis
- hernia
Abdominal Wall
- Muscle strain
- herpes zoster
- hernia
What are unusual casues for acute abdominal pain in a patient without obvious cause?
- Narcotic withdrawal
- sickle cell crisis
- porphyria
- heavy metal poisoning
What are risk factors for pancreatic cancer?
- Smoking
- family history of pancreatic cancer
- history of pancreatitis
- diabetes mellitus
What are the typical presenting symptoms of pancreatic cancer?
- painless jaundice
- depression
- LOW
- abdo pain later in the disease
What are the most common risk factors for pancreatitis?
- alcohol use
- gallstones
A normal wcc rules out appendicitis. True or false?
False
Imaging study of choice for acute RUQ pain
Ultrasonography
Imaging study of choice for acute RLQ
CT
What is the imaging of choice for evaluating pregnant women with RLQ pain
Ultrasonography
In what circumstances are plain radiographs of the abdomen helpful in evaluation of abdominal pain?
- Detecting free air under diaphragm
- finding abnormal calcifications (such as kidney stones)
- diagnosing bowel obstruction with multiple dilated loops and air-fluid levels
What two tests combined are 95% sensitive for ectopic pregnancy?
- Transvaginal ultrasonography
- Human chorionic gonadotropin level greater than 25 mIU per mL