Epigastric abdominal pain: Difference between revisions
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*CBC | *CBC | ||
*Chem | *Chem | ||
*LFTs | *[[LFTs]] | ||
*Lipase | *Lipase | ||
*Coags | *Coags | ||
* | *[[Urinalysis]] | ||
*Urine pregnancy (females) | *Urine pregnancy (females) | ||
*?ECG (if >50 or at risk for cardiac disease) | *?[[ECG]] (if >50 or at risk for cardiac disease) | ||
*?[[RUQ US]] | *?[[RUQ US]] | ||
*?CXR | *?[[CXR]] | ||
**Consider if at risk for perforated ulcer | **Consider if at risk for perforated ulcer | ||
==Management== | ==Management== | ||
*Treat underlying disease process | *Treat underlying disease process | ||
*Consider GI | *Consider PO antacid (e.g. [[Bismuth subsalicylate|Maalox]] Plus) | ||
**The addition of viscous [[lidocaine]] 2% and/or Donnatol (i.e. "GI Cocktail") is no more effective than plain liquid antacid<ref>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.</ref> | |||
==Disposition== | ==Disposition== | ||
Line 33: | Line 34: | ||
==External Links== | ==External Links== | ||
== | ==References== | ||
<references/> | <references/> | ||
[[Category:GI]] | [[Category:GI]] | ||
[[Category:Symptoms]] |
Revision as of 15:22, 14 September 2019
Background
- This page outlines the general approach to adult epigastric pain
Clinical Features
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
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
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.