ABDOMINAL PAIN

 

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.

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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

 

Treatment:

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

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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