History in People With Acute Abdominal Pain
Questions That Doctors Ask | Possible Responses | Possible Causes or Source |
|---|---|---|
Where is the pain? | See figure Causes of Abdominal Pain by Location. | |
What is the pain like? | Waves of sharp pain that “take the breath away” | Renal or biliary colic (episodes of intense pain in the kidneys or gallbladder) |
Waves of dull pain with vomiting | ||
Colicky pain that becomes steady | Strangulating intestinal obstruction (blockage that cuts off the blood supply to the intestines) Mesenteric ischemia (blockage of blood flow to part of the intestines due to a blood clot or buildup of fatty materials in an artery) | |
Sharp, constant pain, worsened by movement | ||
Tearing pain | Aortic dissection (a tear in the inner layer of the aorta) | |
Dull ache | Kidney infection | |
Have you had it before? | Yes | Recurring problems such as peptic ulcer disease, gallstones, diverticulitis, or mittelschmerz (pain during ovulation, usually the middle of the menstrual cycle) |
Did the pain begin suddenly? | Sudden ("like a light switching on”) | Ruptured ectopic pregnancy Twisting of an ovary or twisting of a testis Some ruptured aneurysms |
Less sudden | Most other causes | |
How severe is the pain? | Severe pain | A tear (perforation) in an organ |
Severe pain but a comparatively normal physical examination | ||
Does the pain travel to any other part of your body? | Right shoulder blade | Gallbladder pain |
Left shoulder region | ||
Pubic bone or vagina | Kidney pain | |
Back | Ruptured aortic aneurysm Sometimes perforated ulcer | |
What relieves the pain? | Antacids | |
Lying as quietly as possible | ||
What other symptoms occur with the pain? | Vomiting that precedes the pain and is followed by diarrhea | |
Delayed vomiting, no bowel movements, and no passing of gas (flatulence) | Sudden (acute) intestinal obstruction | |
Severe vomiting that precedes intense pain in the upper middle of the abdomen, left chest, or shoulder |