History in People With Acute Abdominal Pain
History in People With Acute Abdominal Pain
Questions That Doctors Ask |
Possible Responses |
Possible Causes or Source |
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Where is the pain? |
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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) |
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Waves of dull pain with vomiting |
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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) |
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Sharp, constant pain, worsened by movement |
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Tearing pain |
Aortic dissection (a tear in the inner layer of the aorta) |
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Dull ache |
Kidney infection |
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Have you had it before? |
Yes |
Recurring problems such as ulcer disease, gallstones, diverticulitis, or mittelschmerz (pain during ovulation, usually the middle of the menstrual cycle) |
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Did the pain begin suddenly? |
Sudden ("like a light switching on”) |
Some ruptured aneurysms |
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Less sudden |
Most other causes |
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How severe is the pain? |
Severe pain |
A tear (perforation) in an organ |
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Severe pain but a comparatively normal physical examination |
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Does the pain travel to any other part of your body? |
Right shoulder blade |
Gallbladder pain |
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Left shoulder region |
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Pubic bone or vagina |
Kidney pain |
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Back |
Ruptured aortic aneurysm Sometimes perforated ulcer |
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What relieves the pain? |
Antacids |
Gastritis |
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Lying as quietly as possible |
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What other symptoms occur with the pain? |
Vomiting that precedes the pain and is followed by diarrhea |
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Delayed vomiting, no bowel movements, and no passing of gas (flatulence) |
Sudden (acute) intestinal obstruction |
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Severe vomiting that precedes intense pain in the upper middle of the abdomen, left chest, or shoulder |