Epigastric abdominal pain: Difference between revisions
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==Workup== | ==Evaluation== | ||
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*Chem | *Chem | ||
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*?[[CXR]] | *?[[CXR]] | ||
**Consider if at risk for perforated ulcer | **Consider if at risk for perforated ulcer | ||
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==Management== | ==Management== | ||
Revision as of 22:01, 31 January 2024
Background
- This page outlines the general approach to adult epigastric pain
Clinical Features
- Pain in the epigastrum
Differential Diagnosis
Epigastric Pain
- Gastroesophageal reflux disease (GERD)
- Peptic ulcer disease with or without perforation
- Gastritis
- Pancreatitis
- Gallbladder disease
- Myocardial Ischemia
- Splenic Infarctionenlargement/rupture/aneurysm
- Pericarditis/Myocarditis
- Aortic dissection
- Hepatitis
- Pyelonephritis
- Pneumonia
- Pyogenic liver abscess
- Fitz-Hugh-Curtis Syndrome
- Hepatomegaly due to CHF
- Bowel obstruction
- SMA syndrome
- Pulmonary embolism
- Bezoar
- Ingested foreign body
Evaluation
Workup
- CBC
- Chem
- LFTs
- Lipase
- Coags
- Urinalysis
- Urine pregnancy (females)
- ?ECG (if >50 or at risk for cardiac disease)
- ?RUQ US
- ?CXR
- Consider if at risk for perforated ulcer
Diagnosis
Management
- Treat underlying disease process
- Consider PO antacid (e.g. Maalox Plus)
Disposition
- Disposition per underlying disease process
See Also
External Links
References
- ↑ Berman DA, Porter RS, Graber M. "The GI Cocktail is no more effective than plain liquid antacid: a randomized, double blind clinical trial." J Emerg Med. 2003 Oct;25(3):239-44.