ABDOMINAL PAIN LOCALIZE D DIFFUSE NONLOCALIZED Gastroentritis Mesenteric Ischemia Bowel Obstruction Irritable Bowel Syndrome Peritonitis Diabetes

Malaria Familial Mediterranean Fever Metabolic Disease

RUQ Cholecystiti s Biliary Colic Congestive Hepatomeg aly Hepatitis Hepatic Abscess Perforated

LUQ Splenic infarct Splenic rupture Splenic abscess Gastritis Gastric Ulcer Pancreatitis

PERIUMBILI CAL Early Appendicitis Gastroenteriti s Bowel Obstruction Ruptured

RLQ Appendicitis Salpingitis Inguinal hernia Ectopic pregnancy Nephrolithia sis Inflammator y bowel disease

LLQ Diverticuliti s Salpingitis Inguinal hernia Ectopic pregnancy Nephrolithia sis Irritable bowel

EPIGAST RIC

PANCREATITI S Dull and steady pain radiation to the back, worsened by eating Rule out: Pain aggravated by food intake (+) recurrent

PERICARDITI S Pain begins at the substernal area and may radiate to the neck, shoulders, back, epigastrium Rule out: (-) substernal

RUPTURED AORTIC ANEURYSM Mild to severe discomfort after radiating to the lower back Rule out: (-) palpable infrarenal

GERD Spontaneous reflex of sour/bitter gastric contents into the mouth Rule out: (-) heartburn

PEPTIC ULCER Etiology: - H. pylori Pain that awakens the patient from sleep, pain precipitated by food (+) nausea & vomiting (+) gnawing

ZOLLINGER ELLISON SYNDROME Ruptured Peptic Ulcer disease plus diarrhea (+) gnawing epigastric pain aggravated by food (+) frequent episodes of loose bowel movement (+) weight loss (+) vomiting Signs of Perforation: (+) black-colored stools

GASTRIC MALIGNANCY (Metastatic gastric Carcinoid tumor) (+) collapsed rectal vault (+) pararectal tenderness

References Fauci, e. (2008). Harrison's Internal Medicine 17th edition. USA: McGraw-Hll Co. McPhee, S. (2010). Current Medical Diagnosis and Treatment. USA: McGraw-Hill Co.