Differential diagnosis: Acute abdominal pain

Surgical

Other surgical causes = Testicular torsion, ischaemic colitis, volvulus, strangulated hernia, Meckel’s diverticulum, mesenteric adenitis, adhesions, hepatic abscess, psoas abscess

Medical

Other medical differentials = Gastroenteritis, constipation, Crohn’s disease, ulcerative colitis, MI, pneumonia, sickle cell crisis, DKA, pyelonephritis, IBS, Budd-Chiari syndrome, addisonian crisis, hypercalcaemia, acute intermittent porphyria, hepatitis 

Gynaecological

Other gynaecological differentials = Salpingitis, pregnancy, fibroid degeneration, Fitz-Hugh–Curtis syndrome, endometriosis

Test yourself with some questions

A patient presents with right upper quadrant pain and a fever. Blood tests show raised inflammatory markers and hyperbilirubinaemia and raised ALP. What is the differential diagnosis?

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What is Charcot’s triad?

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Which imaging would you consider in this patient?

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Ultrasound confirms a common bile duct stone. How would you manage the patient?

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Try some OSCE stations

  1. Abdominal pain history
  2. Acute pancreatitis history
  3. Acute assessment – abdominal pain
  4. Acute assessment – abdominal pain II
  5. More here
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