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Abdominal pain: defined as any pain occuring between the ribs and the pelvis. Can be acute, chronic or caused by trauma. Traditionally very hard to diagnose, therefore good history-taking is vital.

Symptoms: abdominal pain can have extreme variations. Assessment should be focussed on “quadrants” and underlying structures:

  • ●  Upper Right: pancreas, liver, gallbladder

  • ●  Upper Left: stomach (eg: ulcer), spleen

  • ●  Lower Right: appendix, urinary tract, ovarian/testicular torsion

  • ●  Lower left: large bowel, urinary tract, ovarian/testicular torsion



  1. Rest and reassure patient in position of comfort

  2. Investigate pain thoroughly using O.P.Q.R.S.T

  3. Investigate history thoroughly using S.A.M.P.L.E

  4. Pre-empt onset of shock- treat for environment

Evacuation: Consider: Sudden unexplained onset of severe pain or constant unexplained pain lasting more than 24 hrs Rapid: Blood in urine, faeces or vomit; acute abdo pain associated with anyone with a uterus of childbearing age; any complications of pregnancy

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