Abdominal Pain

Gather a detailed History, Vital Signs, Physical Exam, CBC-Diff, BMP, Pancreatic and Liver Enzymes, Urianalysis
and Electrolytes

RUQ RLQ
Location

Murphy’s Sign
Appendicitis
LLQ
Yes No

Fever, No Fever, No Acute Onset, Fever,

leukocytosis, leukocytosis, Diverticulitis Nausea, Anorexia,
Acute constant “pain comes Vomiting
pain and goes”
Presecense
of fistula,
Leukocytosis, Fever, abcess,
Constipation/Diarrhea perforation Focused Physical
Biliary Colic or Exam with
Acute
Cholecystitis obstruction Rebound
tenderness test
and psoas sign
Abdominal Abdominal CT Yes No and Abdominal
Ultrasound Ultrasound
Perform
Abdominal
Ultrasound and Admit, NPO,
IV Clear Diet,
HIDA Scan PO
Antibiotics,
Gallstones on surgical antibiotics
Imaging. consult 10 days)
Positive
Pain Management, findings.
Gallstones on imaging. Diet odification Admit pt, prep
Tx. Antibiotics, Iv Fluids, for emergency
ERCP and pain surgery
Persisting Symptoms
management, diet (consult, NPO,
Consider
modification antibiotics)
Cholecystectomy