What Is the Accuracy of the Physical Exam in Intra-abdominal Emergencies? Does Administration of Pain Medication Alter the Accuracy of the Physical Examination?
Abdominal pain is one of the most frequent chief complaints encountered in the emergency department, and the physical examination is a key component in generating a differential diagnosis and treatment plan. Knowledge of the embryologic origins of the intra-abdominal organs and their innervation helps to narrow the differential diagnosis and focus laboratory and imaging studies. Non-specific or generalized abdominal pain presents a difficult diagnostic challenge and should be treated with a high index of suspicion. Pain medications should not be withheld as studies show they are safe and do not adversely affect physical exam findings.
KeywordsAbdominal examination Abdominal pain and analgesia Embryologic abdominal organs Epigastric pain Left lower quadrant pain Right lower quadrant pain Visceral and somatic pain
- 5.Sherman R. Abdominal Pain. In: Walker HK, Hall WD, Hurst JW, editors. Clinical methods: the history, physical, and laboratory examinations. 3rd ed. Boston: Butterworths; 1990. Chapter 86.Google Scholar
- 20.Manterola C, Vial M, Moraga J, Astudillo P. Analgesia in patients with acute abdominal pain. Cochrane Database Syst Rev. 2011;1:CD005660.Google Scholar