Abdominal Pain – Chronology

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Chronology in conjunction with location and associated symptoms generally will help narrow down the diagnostic possibilities in acute abdominal pain

ABRUPT OR RAPID

Generally suggests serious pathology such as acute ischaemia, perforation or haemorrhage

  • Ischaemia e.g. ovarian torsion, testicular torsion, mesenteric ischaemia
  • Perforated viscus e.g. perforated ulcer, perforated diverticula, ruptured aneurysm, ruptured ovarian cyst
  • Haemorrhage e.g. ruptured aorthic aneurysm, ruptured ectopic pregnancy

GRADUAL 

  • Infection or inflammatory e.g. appendicitis, diverticulitis, cholecystitis, colitis, hepatitis, pyelonephritis, cystitis

COLICKY

  • Hollow viscus obstruction e.g. bowel obstruction, ureteric colic

NB biliary ‘colic’ is not colicky but constant due to gall bladder distension

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