Evaluation of abdominal pain

This article discusses the approach to evaluation of abdominal pain in the Emergency Department setting. The physiologic differences among visceral, somatic, and referred pain are reviewed, as is the clinical significance of anorexia, nausea, and vomiting. The correlation of historical facts, interrelationships of symptoms, and pain patterns with specific intra-abdominal processes is reviewed. Recommendations for high-yield expedient laboratory studies to facilitate diagnosis are provided. Proficiency in the recognition and interpretation of these clinical symptoms, physical signs, laboratory data, ECGs, and radiographic findings is important when evaluating acutely ill, uncooperative, or unresponsive patients.