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Visceral pain
Somatic /parietal pain
Refered pain
Visceral pain
GIT cardiopulmonary
Genitourinary Neurological
Time/mode of onset
Woken up from sleep
Abrupt/severe vs gradual
Intermittent pain
Location
Four basic quadrant( RUQ,RLQ,LUQ,LLQ)
Intermittent cramping
Sundden increase
Menstrual hx
Tracel
Medicatins
Co-morbid
Contributing factor
Anorexia
Nausea/vomiting
Loose stool
Bleeding
Constipation
Dysuria
Sob
Chest pain
Associated symptoms
GI
Diarrhea /vomiting
Constipation
Bleeding
Distension
Hepatobiliary
Jaundice
Fever
Urological
Dysuria
Oliguria/ Anuria
Gynea
LMP
Infection
Fever
Malaise
Physical examination
FBC
RP and Electrolytes , amylase, lipase
UFEME
ECG
2)IMAGING
-CXR- to detect free air ,
-AXR-to screening for obstruction, sigmoid volvulus,
perforation, or severe constipation
-ULTRASOUND: US examination can visualize the
gallbladder, pancreas, kidneys and ureters, urinary
bladder volume, and aortic dimension
-CT ABDOMEN
Treatment
1) SYMPTOMATIC RELIEF
Opioid analgesia relieves pain and will not obscure
abdominal findings, delay diagnosis, or lead to
increased morbidity/mortality.
Administer antiemetics as needed
Consider placement of nasogastric and urinary
catheters. Nasogastric aspirate may confirm upper
GI bleeding, and nasogastric suction may be used to
decompress a bowel obstruction. A urinary catheter
will relieve bladder obstruction, and hourly urine
output helps to gauge renal perfusion.
Haemodynamically unstable