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Abdominal pain or pain in the belly is the reason for around 5% of all emergency department visits. It is a symptom but may signify a life-threatening condition underneath.
Examination, level of emergency and urgency of diagnosis and management depends on the cause of the pain. All patients with abdominal pain do not require diagnostic tests. Sometimes, clinical evaluation alone is sufficient for diagnosis and management.
Some of the major factors that are assessed by emergency physicians include:-
If the cause cannot be ascertained and the patient appears ill, laboratory diagnostic methods may be employed to detect the cause. Usual tests include complete blood counts, electrolytes assessment, creatinine and BUN levels in blood, liver and renal function tests etc.
Next imaging studies are prescribed. These include ultrasonography, abdominal CT scan, abdominal MRI scan etc. Abdominal ultrasound is one of the commonest used and best non-invasive techniques to detect cause of abdominal pathology.
Urine and stool examination in the laboratory are also prescribed to detect pathology. Other ancillary tests include Electrocardiography (ECG), Arterial Blood gas analysis (ABG) etc.
Pain is managed right away usually with morphine sulfate at 0.5-0.1 mg/kg or 2-4 mg IV or IM. Fluids mainly via intravenous routes are offered to patients with severe abdominal pain. This is because most patients with serious abdominal pain are dehydrated.
Antibiotics are prescribed for acute inflammatory processes such as cholecystitis, appendicitis and diverticulitis. A nasogastric tube may be placed in the stomach and some patients may require blood transfusion as well.
Those with surgical causes of pain abdomen like cholesystitis (gall bladder stone), appendicitis etc. may require emergency surgery for management.