Diffuse abdominal pain

Differential Diagnosis

Diffuse Abdominal pain

• Abdominal aortic aneurysm
  • Aortocaval fistula
• Acute gastroenteritis
• Aortoenteric fisulta
• Appendicitis (early)
• Bowel obstruction
  • Large bowel obstruction
    • Ogilvie's syndrome
  • Small bowel obstruction
  • Malignant bowel obstruction
• Bowel perforation
• Diabetic ketoacidosis
• Gastroparesis
• Hernia
• Hypercalcemia
• Inflammatory bowel disease
• Mesenteric ischemia
  • Mesenteric vein thrombosis
• Pancreatitis
• Peritonitis
• Sickle cell crisis
• Spontaneous bacterial peritonitis
• Volvulus

Extra-abdominal Sources of Abdominal pain

• MI
• Aortic Dissection
• PNA
• PE
• Testicular Torsion
• Herpes Zoster
• Muscle spasm
• Spinal pathology
• Strep Pharyngitis (peds)
• Mononucleosis
• DKA
• ETOH Ketoacidosis
• Uremia
• Sickle Cell Crisis
• SLE
• Vasculitis
• Glaucoma
• Hyperthyroidism
• Methanol Poisoning
• Heavy Metal toxicity
• Addison's disease
• Porphyria
  • Acute intermittent porphyria
• Paroxysmal nocturnal hemoglobinuria
• Black widow spider bite

Evaluation

Workup

• CBC
• Chem
• LFTs
• Lipase
• Coags
• Urinalysis
• Urine pregnancy (female)
• ECG (>40 yo)
• Guaiac
• ?Lactate
• ?CT abd/pelvis

Management

• Treat underlying disease process
• Opioid pain medication (e.g. morphine) may improve localization of physical exam

Disposition

• Disposition per underlying disease process

See Also

• Abdominal Pain
• Abdominal Pain (Peds)