The differential diagnosis of abdominal pain is extensive. We have already discussed the characteristics of intestinal colics and discussed how to differentiate the three major types of abdominal pain; visceral, referred and somatic.
There may on occasion be some confusion about whether the patient's pain is abdominal or not. Severe pain from aortic dissection or myocardial infarction may suggest an abdominal catastrophe. Pneumonia or pulmonary infarction may sometimes suggest a pain in the upper abdomen. The pain of neuritis is often puzzling until the cause such as Herpes Zoster is evident.
The clinician needs to consider the characteristics of the pain and other associated symptoms and signs which should point him/her in the right direction.
The following table only touches on the breath of diagnosis possible.
|Other, Intestinal colic (gastroenteritis, poison)|
|Cholecystitis and Biliary colic|
|Perforated hollow organ|
|Mesenteric ischaemia (Venous, Arterial [Large vessel, Small vessel])|
|Symptomatic or ruptured aneurysm (Aortic, Iliac, Other aneurysms)|
|Torsion of appendix epiploicae|
|Spontaneous retroperitoneal haemorrhage|
|Rectus Sheath Hematoma|
|Complicated ovarian cyst/tumor (Bleed or Torsion)|
|Sickle cell disease|