Abdominal pain has a broad differential, with multiple life-threatening causes as well as much more benign etiologies. It can be difficult to "work up" this presenting concern in an outpatient clinic, leading some clinicians to (prematurely) refer patients to the Emergency Department or take a "shot-gun approach" to testing. Likely pathologies also vary by age. Unnecessary abdominal imaging (plain radiographs, CT scans) increases healthcare costs and radiation exposure for patients. Ultrasonography continues to gain momentum as a preferred first imaging modality. Fear of "masking" the diagnosis by providing analgesia results in unnecessary patient discomfort. In this review session, we will consider abdominal pain by location but also quality and presentation, allowing us to use understanding of (patho)physiology to aid in diagnosis.
Learning Objectives 1. Develop appropriate differential diagnoses for acute abdominal pain based on where (and if) it is localized, considering non-gastrointestinal pathologies such as gonadal torsion and pyelonephritis, as well as patient age and co-morbidity. 2. Assess available evidence and local resources in leveraging imaging modalities and other laboratory testing when managing acute abdominal pain. 3. Provide patient guidance in the face of uncertainty, including pain control and reasons to seek reevaluation.
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