🕷️ Crawler Inspector

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Raw Queries and Responses

1. Shard Calculation

Query:

Response:

Calculated Shard: 152 (from laksa121)

2. Crawled Status Check

Query:

curl -X POST \
  'http://laksa152.int.ahrefs:8124/' \
  -H 'Content-Type: text/plain' \
  -H 'X-ClickHouse-Database: crawler3' \
  -H 'Authorization: Basic YXBpOg==' \
  -d 'SELECT getAhrefsURLFromUnparsed(src_unparsed) AS found_url, ifNull(toUnixTimestamp(download_stamp), 0) AS crawl_time, ifNull(toUnixTimestamp(props_url_first_seen), 0) AS first_indexed_time, download_http_code AS http_code, src_unparsed AS src_unparsed, src_root_hash AS src_root_hash, history_drop_reason AS history_drop_reason, meta_title AS meta_title, meta_descriptions AS meta_descriptions, attrs_boilerpipe_text AS attrs_boilerpipe_text, attrs_markdown AS attrs_markdown, attrs_readable_markdown AS attrs_readable_markdown, meta_canonical AS meta_canonical FROM crawler3.page_info_local FINAL PREWHERE (src_root_hash, src_unparsed) IN ((getAhrefsRootHashFromUnparsed(getAhrefsUnparsedNoserviceFromURL(\'https://en.wikipedia.org/wiki/Abdominal_pain\')), getAhrefsUnparsedNoserviceFromURL(\'https://en.wikipedia.org/wiki/Abdominal_pain\'))) FORMAT JSONEachRow'

Response:

{"found_url":"https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain","crawl_time":1773121772,"first_indexed_time":1375989245,"http_code":200,"src_unparsed":"org,wikipedia!en,\/wiki\/Abdominal_pain s443","src_root_hash":"17790707453426894952","history_drop_reason":null,"meta_title":"Abdominal pain - Wikipedia","meta_descriptions":[],"attrs_boilerpipe_text":"From Wikipedia, the free encyclopedia\n\"Stomach ache\" redirects here. For the 2014 album by Frank Iero, see\nStomachaches (album)\n.\nAbdominal pain\nOther names\nStomach ache, tummy ache, belly ache, belly pain, gastralgia, stomach pain\nAbdominal pain can be characterized by the region it affects.\nSpecialty\nGastroenterology\n,\ngeneral surgery\nComplications\nAnorexia\nCauses\nSerious\n:\nAppendicitis\n, perforated\nstomach ulcer\n,\npancreatitis\n, ruptured\ndiverticulitis\n,\novarian torsion\n,\nvolvulus\n, ruptured\naortic aneurysm\n,\nlacerated spleen\nor liver,\nischemic colitis\n,\nischaemic myocardial conditions\n[\n1\n]\nCommon\n:\nGastroenteritis\n,\nirritable bowel syndrome\n[\n2\n]\nAbdominal pain\n, also known as a\nstomach ache\n, is a\nsymptom\nassociated with both non-serious and serious medical issues. Since the abdomen contains most of the body's vital organs, it can be an indicator of a wide variety of diseases. Given that, approaching the examination of a person and planning of a\ndifferential diagnosis\nis extremely important.\n[\n3\n]\nCommon causes of\npain\nin the\nabdomen\ninclude\ngastroenteritis\nand\nirritable bowel syndrome\n.\n[\n3\n]\nAbout 15% of people have a more serious underlying condition such as\nappendicitis\n, leaking or ruptured\nabdominal aortic aneurysm\n,\ndiverticulitis\n, or\nectopic pregnancy\n.\n[\n2\n]\nIn a third of cases, the exact cause is unclear.\n[\n2\n]\nThe onset of abdominal pain can be abrupt, quick, or gradual. Sudden onset pain happens in a split second. Rapidly onset pain starts mild and gets worse over the next few minutes. Pain that gradually intensifies only after several hours or even days has passed is referred to as gradual onset pain.\n[\n4\n]\nOne can describe abdominal pain as either continuous or sporadic and as\ncramping\n, dull, or aching. The characteristic of cramping abdominal pain is that it comes in brief waves, builds to a peak, and then abruptly stops for a period during which there is no more pain. The pain flares up and off periodically. The most common cause of persistent dull or aching abdominal pain is edema or distention of the wall of a hollow viscus. A dull or aching pain may also be felt due to a stretch in the liver and spleen capsules.\n[\n4\n]\nThe most frequent reasons for abdominal pain are\ngastroenteritis\n(13%),\nirritable bowel syndrome\n(8%), urinary tract problems (5%),\ninflammation of the stomach\n(5%) and\nconstipation\n(5%). In about 30% of cases, the cause is not determined. About 10% of cases have a more serious cause including gallbladder (\ngallstones\nor\nbiliary dyskinesia\n) or\npancreas\nproblems (4%),\ndiverticulitis\n(3%),\nappendicitis\n(2%) and\ncancer\n(1%).\n[\n2\n]\nMore common in those who are older,\nischemic colitis\n,\n[\n5\n]\nmesenteric ischemia\n, and\nabdominal aortic aneurysms\nare other serious causes.\n[\n6\n]\nAcute abdomen\nis a condition where there is a sudden onset of severe abdominal pain requiring  immediate recognition and management of the underlying cause.\n[\n7\n]\nThe underlying cause may involve infection,\ninflammation\n,\nvascular occlusion\nor bowel obstruction.\n[\n7\n]\nThe pain may elicit\nnausea\nand\nvomiting\n,\nabdominal distention\n,\nfever\nand signs of\nshock\n.\n[\n7\n]\nA common condition associated with acute abdominal pain is\nappendicitis\n.\n[\n8\n]\nHere is a list of acute abdomen causes:\nSurgical causes\n[\nedit\n]\nSource:\n[\n7\n]\nInflammatory\n[\nedit\n]\nInfections such as\nappendicitis\n,\ncholecystitis\n,\npancreatitis\n,\npyelonephritis\n,\nPeritonitis\n,\npelvic inflammatory disease\n,\nhepatitis\n,\nmesenteric adenitis\n, or a subdiaphragmatic\nabscess\n.\nPerforation\nof a\npeptic ulcer\n, a\ndiverticulum\n, or the\ncaecum\n.\nComplications of\ninflammatory bowel disease\n, such as\nCrohn's disease\nor\nulcerative colitis\n.\nMechanical\n[\nedit\n]\nSmall bowel\nobstruction\nsecondary to adhesions caused by previous surgeries,\nintussusception\n,\nhernias\n, benign or malignant\nneoplasms\n.\nLarge bowel\nobstruction\ncaused by\ncolorectal cancer\n,\ninflammatory bowel disease\n,\nvolvulus\n,\nfecal impaction\n, or\nhernia\n.\nVascular\n[\nedit\n]\nocclusive\nintestinal ischemia\n, usually caused by\nthromboembolism\nof the\nsuperior Mesenteric artery.\nReferred pain\n[\nedit\n]\nSource:\n[\n9\n]\nViscero-visceral referral: happens when one organ with afferent nerves close to another organ is sensitized or inflamed (in this case any of the abdominal viscera)\n[\n10\n]\nViscero-somatic referral: any pain in the viscera that causes pain in the muscle, bone, and skin (of the abdomen in case of abdominal pain)\nSomatic-visceral referral: pain in the skin, muscles, and bone that causes referred pain in the viscera (of the abdomen such as the stomach, kidneys, bladder, etc.)\nMedical causes\n[\nedit\n]\nSource:\n[\n7\n]\nAcute pancreatitis\n.\nSickle cell anemia\n.\nDiabetic ketoacidosis\n(DKA).\nAdrenal crisis\n.\nPyelonephritis\n.\nLead poisoning\n.\nFamilial Mediterranean fever\n(FMF).\nGynecological causes\n[\nedit\n]\nSource:\n[\n11\n]\nPelvic inflammatory disease\n(PID) and abscess.\nEctopic pregnancy\n.\nHemorrhagic\novarian cyst\n.\nAdnexal or\novarian torsion\n.\nA more extensive list includes the following:\n[\ncitation needed\n]\nGastrointestinal\nGI tract\nInflammatory:\ngastroenteritis\n,\nappendicitis\n,\ngastritis\n,\nesophagitis\n,\ndiverticulitis\n,\nCrohn's disease\n,\nulcerative colitis\n,\nmicroscopic colitis\nObstruction:\nhernia\n,\nintussusception\n,\nvolvulus\n, post-surgical\nadhesions\n,\ntumors\n, severe\nconstipation\n,\nhemorrhoids\nVascular:\nembolism\n,\nthrombosis\n,\nhemorrhage\n,\nsickle cell disease\n,\nabdominal angina\n, blood vessel compression (such as celiac artery compression syndrome),\nsuperior mesenteric artery syndrome\n,\npostural orthostatic tachycardia syndrome\nDigestive\n:\npeptic ulcer\n,\nlactose intolerance\n,\nceliac disease\n,\nfood allergies\n,\nindigestion\nGlands\nBile system\nInflammatory:\ncholecystitis\n,\ncholangitis\nObstruction:\ncholelithiasis\nLiver\nInflammatory:\nhepatitis\n,\nliver abscess\nPancreatic\nInflammatory:\npancreatitis\nRenal and urological\nInflammation:\npyelonephritis\n,\nbladder infection\nObstruction:\nkidney stones\n,\nurolithiasis\n,\nurinary retention\nVascular:\nleft renal vein entrapment\nGynaecological or obstetric\nInflammatory:\npelvic inflammatory disease\nMechanical:\novarian torsion\nEndocrinological:\nmenstruation\n,\nMittelschmerz\nTumors:\nendometriosis\n,\nfibroids\n,\novarian cyst\n,\novarian cancer\nPregnancy: ruptured\nectopic pregnancy\n,\nthreatened abortion\nAbdominal wall\nmuscle strain or trauma\nmuscular infection\nneurogenic\npain:\nherpes zoster\n,\nradiculitis\nin\nLyme disease\n,\nabdominal cutaneous nerve entrapment syndrome\n(ACNES),\ntabes dorsalis\nReferred pain\nfrom the\nthorax\n:\npneumonia\n,\npulmonary embolism\n,\nischemic heart disease\n,\npericarditis\nfrom the\nspine\n:\nradiculitis\nfrom the\ngenitals\n:\ntesticular torsion\nMetabolic disturbance\nuremia\n,\ndiabetic ketoacidosis\n,\nporphyria\n,\nC1-esterase inhibitor deficiency\n, adrenal insufficiency,\nlead poisoning\n,\nblack widow spider\nbite,\nnarcotic\nwithdrawal\nBlood vessels\naortic dissection\n,\nabdominal aortic aneurysm\nImmune system\nsarcoidosis\nvasculitis\nfamilial Mediterranean fever\nIdiopathic\nirritable bowel syndrome\n(IBS) (affecting up to 20% of the population, IBS is the most common cause of recurrent and intermittent abdominal pain)\nThe location of abdominal pain can provide information about what may be causing the pain. The abdomen can be divided into four regions called quadrants. Locations and associated conditions include:\n[\n12\n]\n[\n13\n]\nDiffuse\nPeritonitis\nVascular:\nmesenteric ischemia\n,\nischemic colitis\n,\nHenoch-Schonlein purpura\n,\nsickle cell disease\n,\nsystemic lupus erythematosus\n,\npolyarteritis nodosa\nSmall\nbowel obstruction\nIrritable bowel syndrome\nMetabolic disorders\n:\nketoacidosis\n,\nporphyria\n,\nfamilial Mediterranean fever\n,\nadrenal crisis\nEpigastric\nHeart:\nmyocardial infarction\n,\npericarditis\nStomach:\ngastritis\n,\nstomach ulcer\n,\nstomach cancer\nPancreas:\npancreatitis\n,\npancreatic cancer\nIntestinal:\nduodenal ulcer\n,\ndiverticulitis\n,\nappendicitis\nRight upper quadrant\nLiver:\nhepatomegaly\n,\nfatty liver\n,\nhepatitis\n,\nliver cancer\n,\nabscess\nGallbladder and biliary tract:\ninflammation\n,\ngallstones\n,\nworm infection\n,\ncholangitis\nColon:\nbowel obstruction\n, functional disorders,\ngas accumulation\n,\nspasm\n, inflammation,\ncolon cancer\nOther:\npneumonia\n,\nFitz-Hugh-Curtis syndrome\nLeft upper quadrant\nSplenomegaly\nColon:\nbowel obstruction\n, functional disorders, gas accumulation, spasm, inflammation, colon cancer\nPeri-umbilical (the area around the umbilicus, i.e., the belly button)\nAppendicitis\nPancreatitis\nInferior myocardial infarction\nPeptic ulcer\nDiabetic ketoacidosis\nVascular:\naortic dissection\n, aortic rupture\nBowel:\nmesenteric ischemia\n,\nCeliac disease\n, inflammation, intestinal spasm, functional disorders,\nsmall bowel obstruction\nLower abdominal pain\nDiarrhea\nColitis\nCrohn's\nDysentery\nHernia\nRight lower quadrant\nColon:\nintussusception\n,\nbowel obstruction\n,\nappendicitis\n(\nMcBurney's point\n)\nRenal:\nkidney stone\n(nephrolithiasis),\npyelonephritis\nPelvic:\ncystitis\n,\nbladder stone\n,\nbladder cancer\n,\npelvic inflammatory disease\n, pelvic pain syndrome\nGynecologic:\nendometriosis\n, intrauterine\npregnancy\n,\nectopic pregnancy\n,\novarian cyst\n,\novarian torsion\n, fibroid (\nleiomyoma\n),\nabscess\n,\novarian cancer\n,\nendometrial cancer\nLeft lower quadrant\nBowel:\ndiverticulitis\n,\nsigmoid colon volvulus\n,\nbowel obstruction\n, gas accumulation,\nToxic megacolon\nRight\nlow back pain\nLiver:\nhepatomegaly\nKidney:\nkidney stone\n(nephrolithiasis), complicated urinary tract infection\nLeft low back pain\nSpleen\nKidney:\nkidney stone\n(nephrolithiasis), complicated urinary tract infection\nLow back pain\nKidney pain (\nkidney stone\n,\nkidney cancer\n,\nhydronephrosis\n)\nUreteral stone\npain\nRegion\nBlood supply\n[\n14\n]\nInnervation\n[\n15\n]\nStructures\n[\n14\n]\nForegut\nCeliac artery\nT5 - T9\nPharynx\nEsophagus\nLower respiratory tract\nStomach\nProximal\nduodenum\nLiver\nBiliary tract\nGallbladder\nPancreas\nMidgut\nSuperior mesenteric artery\nT10 – T12\nDistal\nduodenum\nCecum\nAppendix\nAscending colon\nProximal\ntransverse colon\nHindgut\nInferior mesenteric artery\nL1 – L3\nDistal\ntransverse colon\nDescending colon\nSigmoid colon\nRectum\nSuperior\nanal canal\nAbdominal pain can be referred to as\nvisceral pain\nor\nperitoneal\npain. The contents of the abdomen can be divided into the\nforegut\n,\nmidgut\n, and\nhindgut\n.\n[\n14\n]\nThe\nforegut\ncontains the\npharynx\n, lower\nrespiratory tract\n, portions of the\nesophagus\n,\nstomach\n, portions of the\nduodenum\n(proximal),\nliver\n,\nbiliary tract\n(including the\ngallbladder\nand\nbile ducts\n), and the\npancreas\n.\n[\n14\n]\nThe midgut contains portions of the\nduodenum\n(distal),\ncecum\n,\nappendix\n,\nascending colon\n, and first half of the\ntransverse colon\n.\n[\n14\n]\nThe hindgut contains the distal half of the transverse colon,\ndescending colon\n,\nsigmoid colon\n,\nrectum\n, and superior\nanal canal\n.\n[\n14\n]\nEach subsection of the gut has an associated visceral afferent nerve that transmits sensory information from the viscera to the spinal cord.\n[\n16\n]\nThe visceral sensory information from the gut traveling to the spinal cord, termed the visceral afferent, is non-specific and overlaps with the somatic afferent nerves, which are very specific.\n[\n17\n]\nTherefore, visceral afferent information traveling to the spinal cord can present in the distribution of the somatic afferent nerve; this is why\nappendicitis\ninitially presents with T10 periumbilical pain when it first begins and becomes T12 pain as the abdominal wall peritoneum (which is rich with somatic afferent nerves) is involved.\n[\n17\n]\nA thorough patient history and physical examination is used to better understand the underlying cause of abdominal pain.\nThe process of gathering a history may include:\n[\n18\n]\nIdentifying more information about the\nchief complaint\nby eliciting a\nhistory of present illness\n; i.e. a narrative of the current symptoms such as the onset, location, duration, character, aggravating or relieving factors, and temporal nature of the pain. Identifying other possible factors may aid in the diagnosis of the underlying cause of abdominal pain, such as recent travel, recent contact with other ill individuals, and for females, a thorough\ngynecologic\nhistory.\nLearning about the patient's past medical history, focusing on any prior issues or surgical procedures.\nClarifying the patient's current medication regimen, including prescriptions, over-the-counter medications, and supplements.\nConfirming the patient's drug and food allergies.\nDiscussing with the patient any family history of disease processes, focusing on conditions that might resemble the patient's current presentation.\nDiscussing with the patient any health-related behaviors (e.g. tobacco use, alcohol consumption, drug use, and sexual activity) that might make certain diagnoses more likely.\nReviewing the presence of non-abdominal symptoms (e.g.,\nfever\n, chills,\nchest pain\n,\nshortness of breath\n,\nvaginal bleeding\n) that can further clarify the diagnostic picture.\nUsing\nCarnett's sign\nto differentiate between\nvisceral pain\nand pain originating in the muscles of the abdominal wall.\n[\n19\n]\nAfter gathering a thorough history, one should perform a\nphysical exam\nin order to identify important physical signs that might clarify the diagnosis, including a\ncardiovascular exam\n, lung exam, thorough abdominal exam, and for females, a\ngenitourinary\nexam.\n[\n18\n]\nAdditional investigations that can aid diagnosis include:\n[\n20\n]\nBlood tests including\ncomplete blood count\n,\nbasic metabolic panel\n,\nelectrolytes\n,\nliver function tests\n,\namylase\n,\nlipase\n,\ntroponin I\n, and for females, a serum\npregnancy test\n.\nUrinalysis\nImaging including chest and abdominal\nX-rays\nElectrocardiogram\nIf diagnosis remains unclear after history, examination, and basic investigations as above, then more advanced investigations may reveal a diagnosis. Such tests include:\n[\n20\n]\nComputed tomography\nof the abdomen\/pelvis\nAbdominal or pelvic\nultrasound\nEndoscopy\nor\ncolonoscopy\nThe management of abdominal pain depends on many factors, including the etiology of the pain. Some behavioural changes implemented to prevent pain include: resting after a meal, chewing food completely and slowly, and avoiding stressful and high excitement situations after a meal. Such at home strategies may reduce the need to seek professional assistance via prevention of future abdominal pain.\n[\n21\n]\nIn the emergency department, a person presenting with abdominal pain may initially require IV fluids due to decreased intake secondary to abdominal pain and possible emesis or vomiting.\n[\n22\n]\nTreatment for abdominal pain includes analgesia, such as non-opioid (ketorolac) and opioid medications (\nmorphine\n,\nfentanyl\n).\n[\n22\n]\nChoice of\nanalgesia\nis dependent on the cause of the pain, as\nketorolac\ncan worsen some intra-abdominal processes.\n[\n22\n]\nPatients presenting to the emergency department with abdominal pain may receive a \"GI cocktail\" that includes an\nantacid\n(examples include\nomeprazole\n,\nfamotidine\n,\nmagnesium hydroxide\n, and\ncalcium carbonate\n) and\nlidocaine\n.\n[\n22\n]\nAfter addressing pain, there may be a role for\nantimicrobial\ntreatment in some cases of abdominal pain.\n[\n22\n]\nButylscopolamine\n(Buscopan) is used to treat cramping abdominal pain with some success.\n[\n23\n]\nSurgical management for causes of abdominal pain includes but is not limited to\ncholecystectomy\n,\nappendectomy\n, and exploratory\nlaparotomy\n.\n[\ncitation needed\n]\nBelow is a brief overview of abdominal pain emergencies.\nCondition\nPresentation\nDiagnosis\nManagement\nAppendicitis\n[\n24\n]\nAbdominal pain, nausea, vomiting, fever\nPeriumbilical pain, migrates to RLQ\nClinical (history and physical exam)\nAbdominal CT\nPatient made NPO (nothing by mouth)\nIV fluids as needed\nGeneral surgery consultation, possible\nappendectomy\nAntibiotics\nPain control\nCholecystitis\n[\n24\n]\nAbdominal pain (RUQ, radiates epigastric), nausea, vomiting, fever,\nMurphy's sign\nClinical (history and physical exam)\nImaging (RUQ ultrasound)\nLabs (\nleukocytosis\n,\ntransamintis\n,\nhyperbilirubinemia\n)\nPatient made NPO (nothing by mouth)\nIV fluids as needed\nGeneral surgery consultation, possible\ncholecystectomy\nAntibiotics\nPain, nausea control\nAcute pancreatitis\n[\n24\n]\nAbdominal pain (sharp epigastric, shooting to back), nausea, vomiting\nClinical (history and physical exam)\nLabs (elevated\nlipase\n)\nImaging (abdominal CT, ultrasound)\nPatient made NPO (nothing by mouth)\nIV fluids as needed\nPain, nausea control\nPossibly consultation of\ngeneral surgery\nor\ninterventional radiology\nBowel obstruction\n[\n24\n]\nAbdominal pain (diffuse, crampy),\nbilious\nemesis\n,\nconstipation\nClinical (history and physical exam)\nImaging (abdominal X-ray, abdominal CT)\nPatient made NPO (nothing by mouth)\nIV fluids as needed\nNasogastric tube\nplacement\nGeneral surgery\nconsultation\nPain control\nUpper GI bleed\n[\n24\n]\nAbdominal pain (epigastric),\nhematochezia\n,\nmelena\n,\nhematemesis\n,\nhypovolemia\nClinical (history & physical exam, including\ndigital rectal exam\n)\nLabs (\ncomplete blood count\n, coagulation profile,\ntransaminases\n,\nstool guaiac\n)\nAggressive IV fluid resuscitation\nBlood transfusion\nas needed\nMedications:\nproton pump inhibitor\n,\noctreotide\nStable patient: observation\nUnstable patient: consultation (\ngeneral surgery\n,\ngastroenterology\n,\ninterventional radiology\n)\nLower\nGI bleed\n[\n24\n]\nAbdominal pain,\nhematochezia\n,\nmelena\n,\nhypovolemia\nClinical (history and physical exam, including\ndigital rectal exam\n)\nLabs (\ncomplete blood count\n, coagulation profile,\ntransaminases\n,\nstool guaiac\n)\nAggressive IV fluid resuscitation\nBlood transfusion\nas needed\nMedications:\nproton pump inhibitor\nStable patient: observation\nUnstable patient: consultation (\ngeneral surgery\n,\ngastroenterology\n,\ninterventional radiology\n)\nPerforated Viscous\n[\n24\n]\nAbdominal pain (sudden onset of localized pain),\nabdominal distension\n, rigid abdomen\nClinical (history and physical exam)\nImaging (abdominal X-ray or CT showing free air)\nLabs (\ncomplete blood count\n)\nAggressive IV fluid resuscitation\nGeneral surgery\nconsultation\nAntibiotics\nVolvulus\n[\n24\n]\nSigmoid colon volvulus\n: Abdominal pain (>2 days, distention, constipation)\nCecal volvulus: Abdominal pain (acute onset), nausea, vomiting\nClinical (history and physical exam)\nImaging (abdominal X-ray or CT)\nSigmoid:\nGastroenterology\nconsultation (\nflexibile sigmoidoscopy\n)\nCecal:\nGeneral surgery\nconsultation (\nright hemicolectomy\n)\nEctopic pregnancy\n[\n24\n]\nAbdominal and pelvic pain, bleeding\nIf ruptured ectopic pregnancy, the patient may present with peritoneal irritation and\nhypovolemic shock\nClinical (history and physical exam)\nLabs:\ncomplete blood count\n, urine pregnancy test followed with quantitative blood\nbeta-hCG\nImaging:\ntransvaginal ultrasound\nIf patient is unstable: IV fluid resuscitation, urgent\nobstetrics and gynecology\nconsultation\nIf patient is stable: continue diagnostic workup, establish\nOBGYN\nfollow-up\nAbdominal aortic aneurysm\n[\n24\n]\nAbdominal pain, flank pain, back pain, hypotension, pulsatile abdominal mass\nClinical (history and physical exam)\nImaging: Ultrasound,\nCT angiography\n, MRA\/\nmagnetic resonance angiography\nIf patient is unstable: IV fluid resuscitation, urgent surgical consultation\nIf patient is stable: admit for observation\nAortic dissection\n[\n24\n]\nAbdominal pain (sudden onset of epigastric or back pain), hypertension, new aortic\nmurmur\nClinical (history and physical exam)\nImaging: Chest X-ray (showing widened\nmediastinum\n),\nCT angiography\n,\nMRA\n,\ntransthoracic echocardiogram\n\/TTE,\ntransesophageal echocardiogram\n\/TEE\nIV fluid resuscitation\nBlood transfusion\nas needed (obtain\ntype and cross\n)\nMedications: reduce blood pressure (\nsodium nitroprusside\nplus\nbeta blocker\nor\ncalcium channel blocker\n)\nSurgery consultation\nLiver injury\n[\n24\n]\nAfter trauma (\nblunt\nor\npenetrating\n), abdominal pain (RUQ), right rib pain, right flank pain, right shoulder pain\nClinical (history and physical exam)\nImaging:\nFAST\nexamination, CT of abdomen and pelvis\nDiagnostic peritoneal aspiration and lavage\nResuscitation (\nadvanced trauma life support\n) with IV fluids (\ncrystalloid\n) and\nblood transfusion\nIf patient is unstable:\ngeneral\nor\ntrauma surgery\nconsultation with subsequent\nexploratory laparotomy\nSplenic injury\n[\n24\n]\nAfter trauma (\nblunt\nor\npenetrating\n), abdominal pain (LUQ), left rib pain, left flank pain\nClinical (history and physical exam)\nImaging:\nFAST\nexamination, CT of abdomen and pelvis\nDiagnostic peritoneal aspiration and lavage\nResuscitation (\nadvanced trauma life support\n) with IV fluids (\ncrystalloid\n) and\nblood transfusion\nIf patient is unstable:\ngeneral\nor\ntrauma surgery\nconsultation with subsequent\nexploratory laparotomy\nand possible\nsplenectomy\nIf patient is stable: medical management, consultation of\ninterventional radiology\nfor possible\narterial embolization\nOne well-known aspect of primary health care is its low prevalence of potentially dangerous abdominal pain causes. Patients with abdominal pain have a higher percentage of unexplained complaints (category \"no diagnosis\") than patients with other symptoms (such as\ndyspnea\nor\nchest pain\n).\n[\n25\n]\nMost people who suffer from stomach pain have a benign issue, like\ndyspepsia\n.\n[\n26\n]\nIn general, it is discovered that 20% to 25% of patients with abdominal pain have a serious condition that necessitates admission to an acute care hospital.\n[\n27\n]\nAbdominal pain is the reason about 3% of adults see their family physician.\n[\n2\n]\nRates of\nemergency department\n(ED) visits in the United States for abdominal pain increased 18% from 2006 through to 2011. This was the largest increase out of 20 common conditions seen in the ED. The rate of ED use for nausea and vomiting also increased 18%.\n[\n28\n]\nSpecial populations\n[\nedit\n]\nMore time and resources are used on older patients with abdominal pain than on any other patient presentation in the emergency department (ED).\n[\n29\n]\nCompared to younger patients with the same complaint, their length of stay is 20% longer, they need to be admitted almost half the time, and they need surgery 1\/3 of the time.\n[\n30\n]\nAge does not reduce the total number of\nT cells\n, but it does reduce their functionality. The elderly person's ability to fight infection is weakened as a result.\n[\n31\n]\nAdditionally, they have changed the strength and integrity of their skin and\nmucous membranes\n, which are physical barriers to infection. It is well known that older patients experience altered pain perception.\n[\n32\n]\nThe challenge of obtaining a sufficient history from an elderly patient can be attributed to multiple factors. Reduced memory or hearing could make the issue worse. It is common to encounter stoicism combined with a fear of losing one's independence if a serious condition is discovered. Changes in mental status, whether acute or chronic, are common.\n[\n33\n]\nUnique clinical challenges arise when pregnant women experience abdominal pain. First off, there are many possible causes of abdominal pain during pregnancy. These include intraabdominal diseases that arise incidentally during pregnancy as well as obstetric or gynecologic disorders associated with pregnancy. Secondly, pregnancy modifies the natural history and clinical manifestation of numerous abdominal disorders.\n[\n34\n]\nThird, pregnancy modifies and limits the diagnostic assessment. For instance, concerns about fetal safety during pregnancy are raised by invasive exams and radiologic testing. Fourth, while receiving therapy during pregnancy, the mother's and the fetus' interests need to be taken into account.\n[\n35\n]\nAbdominal distension\nAbdominal mass\n^\nPatterson JW, Dominique E (14 November 2018). \"Acute Abdomenal\".\nStatPearls\n.\nPMID\n \n29083722\n.\n^\na\nb\nc\nd\ne\nViniol A, Keunecke C, Biroga T, Stadje R, Dornieden K, Bösner S, et al. (October 2014).\n\"Studies of the symptom abdominal pain—a systematic review and meta-analysis\"\n.\nFamily Practice\n.\n31\n(5):\n517–\n29.\ndoi\n:\n10.1093\/fampra\/cmu036\n.\nPMID\n \n24987023\n.\n^\na\nb\nHopcroft K, Forte V (2020).\n\"Abdomen\"\n.\nSymptom Sorter\n(6th ed.). Boca Raton: CRC Press. pp. \n9–\n17.\nISBN\n \n9780367468101\n.\n^\na\nb\nSherman R (1990).\nAbdominal Pain\n. Butterworths.\nISBN\n \n978-0-409-90077-4\n.\nPMID\n \n21250252\n. Retrieved\n28 December\n2023\n.\n^\nHung A, Calderbank T, Samaan MA, Plumb AA, Webster G (1 January 2021).\n\"Ischaemic colitis: practical challenges and evidence-based recommendations for management\"\n.\nFrontline Gastroenterology\n.\n12\n(1):\n44–\n52.\ndoi\n:\n10.1136\/flgastro-2019-101204\n.\nISSN\n \n2041-4137\n.\nPMC\n \n7802492\n.\nPMID\n \n33489068\n.\n^\nSpangler R, Van Pham T, Khoujah D, Martinez JP (2014).\n\"Abdominal emergencies in the geriatric patient\"\n.\nInternational Journal of Emergency Medicine\n.\n7\n43.\ndoi\n:\n10.1186\/s12245-014-0043-2\n.\nPMC\n \n4306086\n.\nPMID\n \n25635203\n.\n^\na\nb\nc\nd\ne\nPatterson JW, Kashyap S, Dominique E (2023),\n\"Acute Abdomen\"\n,\nStatPearls\n, Treasure Island (FL): StatPearls Publishing,\nPMID\n \n29083722\n, retrieved\n23 September\n2023\n^\n\"Appendicitis\"\n.\nThe Lecturio Medical Concept Library\n. Retrieved\n1 July\n2021\n.\n^\nArendt-Nielsen L, Svensson P (March 2001).\n\"Referred Muscle Pain: Basic and Clinical Findings\"\n.\nThe Clinical Journal of Pain\n.\n17\n(1):\n11–\n19.\ndoi\n:\n10.1097\/00002508-200103000-00003\n.\nISSN\n \n0749-8047\n.\nPMID\n \n11289083\n.\n^\nCollantes Celador E, Rudiger J, Tameem A, eds. (2022).\nEssential Notes in Pain Medicine\n(1st ed.). United Kingdom: Oxford University Press.\ndoi\n:\n10.1093\/med\/9780198799443.001.0001\n.\nISBN\n \n978-0-19-879944-3\n.\n^\nBurnett LS (April 1988). \"Gynecologic causes of the acute abdomen\".\nThe Surgical Clinics of North America\n.\n68\n(2):\n385–\n398.\ndoi\n:\n10.1016\/s0039-6109(16)44484-1\n.\nISSN\n \n0039-6109\n.\nPMID\n \n3279553\n.\n^\nMasters P (2015).\nIM Essentials\n. American College of Physicians.\nISBN\n \n978-1-938921-09-4\n.\n^\nLeBlond RF (2004).\nDiagnostics\n. US: McGraw-Hill Companies, Inc.\nISBN\n \n978-0-07-140923-0\n.\n^\na\nb\nc\nd\ne\nf\nMoore KL (2016). \"11\".\nThe Developing Human Tenth Edition\n. Philadelphia, PA: Elsevier, Inc. pp. \n209–\n240.\nISBN\n \n978-0-323-31338-4\n.\n^\nHansen JT (2019). \"4: Abdomen\".\nNetter's Clinical Anatomy, 4e\n. Philadelphia, PA: Elsevier. pp. \n157–\n231.\nISBN\n \n978-0-323-53188-7\n.\n^\nDrake RL, Vogl AW, Mitchell AW (2015). \"4: Abdomen\".\nGray's Anatomy For Students\n(Third ed.). Churchill Livingstone Elsevier. pp. \n253–\n420.\nISBN\n \n978-0-7020-5131-9\n.\n^\na\nb\nNeumayer L, Dangleben DA, Fraser S, Gefen J, Maa J, Mann BD (2013). \"11: Abdominal Wall, Including Hernia\".\nEssentials of General Surgery, 5e\n. Baltimore, MD: Wolters Kluwer Health.\n^\na\nb\nBickley L (2016).\nBates' Guide to Physical Examination & History Taking\n. Philadelphia, Pennsylvania: Lippincott Williams & Wilkins.\nISBN\n \n978-1-4698-9341-9\n.\n^\nKaren M. Myrick, Laima Karosas (6 December 2019).\nAdvanced Health Assessment and Differential Diagnosis: Essentials for Clinical Practice\n. Springer Publishing Company. p. 250.\nISBN\n \n978-0-8261-6255-7\n.\n^\na\nb\nCartwright SL, Knudson MP (April 2008).\n\"Evaluation of acute abdominal pain in adults\"\n.\nAmerican Family Physician\n.\n77\n(7):\n971–\n8.\nPMID\n \n18441863\n.\n^\n\"Indigestion: MedlinePlus Medical Encyclopedia\"\n.\nmedlineplus.gov\n. Retrieved\n2 May\n2023\n.\n^\na\nb\nc\nd\ne\nMahadevan SV.\nEssentials of Family Medicine 6e\n. p. 149.\n^\nTytgat GN (2007). \"Hyoscine butylbromide: a review of its use in the treatment of abdominal cramping and pain\".\nDrugs\n.\n67\n(9):\n1343–\n57.\ndoi\n:\n10.2165\/00003495-200767090-00007\n.\nPMID\n \n17547475\n.\nS2CID\n \n46971321\n.\n^\na\nb\nc\nd\ne\nf\ng\nh\ni\nj\nk\nl\nm\nSherman SC, Cico SJ, Nordquist E, Ross C, Wang E (2016).\nAtlas of Clinical Emergency Medicine\n. Wolters Kluwer.\nISBN\n \n978-1-4511-8882-0\n.\n^\nViniol A, Keunecke C, Biroga T, Stadje R, Dornieden K, Bösner S, et al. (2014). \"Studies of the symptom abdominal pain—a systematic review and meta-analysis\".\nFamily Practice\n.\n31\n(5):\n517–\n529.\ndoi\n:\n10.1093\/fampra\/cmu036\n.\nISSN\n \n1460-2229\n.\nPMID\n \n24987023\n.\n^\nGulacti U, Arslan E, Ooi MW, Tuck J, Mattu A, Dubosh NM, et al. (1 February 2001). \"Abdominal Pain and Emergency Department Evaluation\".\nEmergency Medicine Clinics of North America\n.\n19\n(1). Elsevier:\n123–\n136.\ndoi\n:\n10.1016\/S0733-8627(05)70171-1\n.\nISSN\n \n0733-8627\n.\nPMID\n \n11214394\n.\n^\nChandramohan R, Pari L, Schrock JW, Lum M, Örnek N, Usta G, et al. (1 May 1991). \"Probability of appendicitis before and after observation\".\nAnnals of Emergency Medicine\n.\n20\n(5). Mosby:\n503–\n507.\ndoi\n:\n10.1016\/S0196-0644(05)81603-8\n.\nISSN\n \n0196-0644\n.\nPMID\n \n2024789\n.\n^\nSkiner HG, Blanchard J, Elixhauser A (September 2014).\n\"Trends in Emergency Department Visits, 2006–2011\"\n.\nHCUP Statistical Brief\n(179). Rockville, MD: Agency for Healthcare Research and Quality.\n^\nBaum SA, Rubenstein LZ (1987). \"Old people in the emergency room: age-related differences in emergency department use and care\".\nJournal of the American Geriatrics Society\n.\n35\n(5):\n398–\n404.\ndoi\n:\n10.1111\/j.1532-5415.1987.tb04660.x\n.\nISSN\n \n0002-8614\n.\nPMID\n \n3571788\n.\nS2CID\n \n30731138\n.\n^\nRodríguez-Lomba E, Pulido-Pérez A, Ricciardi R, Marcello PW, Kuki I, Nakane S, et al. (1 February 1976). \"Abdominal pain: An analysis of 1,000 consecutive cases in a university hospital emergency room\".\nThe American Journal of Surgery\n.\n131\n(2). Elsevier:\n219–\n223.\ndoi\n:\n10.1016\/0002-9610(76)90101-X\n.\nISSN\n \n0002-9610\n.\nPMID\n \n1251963\n.\n^\nWeyand CM, Goronzy rJ (2016).\n\"Aging of the Immune System. Mechanisms and Therapeutic Targets\"\n.\nAnnals of the American Thoracic Society\n.\n13\n(Suppl 5). American Thoracic Society:\nS422–\nS428.\ndoi\n:\n10.1513\/AnnalsATS.201602-095AW\n.\nPMC\n \n5291468\n.\nPMID\n \n28005419\n.\n^\nSherman ED, Robillard E (1964). \"Sensitivity to Pain in Relationship to Age\".\nJournal of the American Geriatrics Society\n.\n12\n(11):\n1037–\n1044.\ndoi\n:\n10.1111\/j.1532-5415.1964.tb00652.x\n.\nISSN\n \n0002-8614\n.\nPMID\n \n14217863\n.\nS2CID\n \n26336124\n.\n^\nIsani MA, Kim ES, Mateu PB, Tormo FB, Thilakarathna K, Xie G, et al. (1 May 2006). \"Abdominal Pain in the Elderly\".\nEmergency Medicine Clinics of North America\n.\n24\n(2). Elsevier:\n371–\n388.\ndoi\n:\n10.1016\/j.emc.2006.01.010\n.\nISSN\n \n0733-8627\n.\nPMID\n \n16584962\n.\n^\nOdubamowo K, Chilaka C, Walker K (2022).\n\"Abdominal pain in late pregnancy (‡24 weeks' gestation)\"\n(PDF)\n.\nObstetrics, Gynaecology and Reproductive Medicine\n.\n32\n(7):\n141–\n151.\ndoi\n:\n10.1016\/j.ogrm.2022.04.008\n.\n^\nSouza Fd, Ferreira CH, Young RC, Cerit L, Lejong M, Louryan S, et al. (1 March 2003). \"Abdominal pain during pregnancy\".\nGastroenterology Clinics of North America\n.\n32\n(1). Elsevier:\n1–\n58.\ndoi\n:\n10.1016\/S0889-8553(02)00064-X\n.\nISSN\n \n0889-8553\n.\nPMID\n \n12635413\n.\nShinar Z, Dembitsky W, Smith ME, Moak JH, Traub SJ, Saghafian S, et al. (1 September 2011). \"Abdominal pain in the ED: a 35 year retrospective\".\nThe American Journal of Emergency Medicine\n.\n29\n(7). W.B. Saunders:\n711–\n716.\ndoi\n:\n10.1016\/j.ajem.2010.01.045\n.\nISSN\n \n0735-6757\n.\nPMID\n \n20825873\n.\nFarmer AD, Aziz Q (2014).\n\"Mechanisms and management of functional abdominal pain\"\n.\nJournal of the Royal Society of Medicine\n.\n107\n(9):\n347–\n354.\ndoi\n:\n10.1177\/0141076814540880\n.\nISSN\n \n0141-0768\n.\nPMC\n \n4206626\n.\nPMID\n \n25193056\n.\nAkasaka E, Sawamura D, Rokunohe D, Sawamura D, Talukdar R, Reddy DN, et al. (1 February 2006). \"Abdominal Pain in Children\".\nPediatric Clinics of North America\n.\n53\n(1). Elsevier:\n107–\n137.\ndoi\n:\n10.1016\/j.pcl.2005.09.009\n.\nISSN\n \n0031-3955\n.\nPMID\n \n16487787\n.\nS2CID\n \n17103933\n.\nAbdominal Pain\nat Wikibooks\nCleveland Clinic\nMayo Clinic","attrs_markdown":"[Jump to content](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#bodyContent)\n\nMain menu\n\nMain menu\n\nmove to sidebar\n\nhide\n\nNavigation\n\n- [Main page](https:\/\/en.wikipedia.org\/wiki\/Main_Page \"Visit the main page [z]\")\n- [Contents](https:\/\/en.wikipedia.org\/wiki\/Wikipedia:Contents \"Guides to browsing Wikipedia\")\n- [Current events](https:\/\/en.wikipedia.org\/wiki\/Portal:Current_events \"Articles related to current events\")\n- [Random article](https:\/\/en.wikipedia.org\/wiki\/Special:Random \"Visit a randomly selected article [x]\")\n- [About Wikipedia](https:\/\/en.wikipedia.org\/wiki\/Wikipedia:About \"Learn about Wikipedia and how it works\")\n- [Contact us](https:\/\/en.wikipedia.org\/wiki\/Wikipedia:Contact_us \"How to contact Wikipedia\")\n\nContribute\n\n- [Help](https:\/\/en.wikipedia.org\/wiki\/Help:Contents \"Guidance on how to use and edit Wikipedia\")\n- [Learn to edit](https:\/\/en.wikipedia.org\/wiki\/Help:Introduction \"Learn how to edit Wikipedia\")\n- [Community portal](https:\/\/en.wikipedia.org\/wiki\/Wikipedia:Community_portal \"The hub for editors\")\n- [Recent changes](https:\/\/en.wikipedia.org\/wiki\/Special:RecentChanges \"A list of recent changes to Wikipedia [r]\")\n- [Upload file](https:\/\/en.wikipedia.org\/wiki\/Wikipedia:File_upload_wizard \"Add images or other media for use on Wikipedia\")\n- [Special pages](https:\/\/en.wikipedia.org\/wiki\/Special:SpecialPages \"A list of all special pages [q]\")\n\n[![](https:\/\/en.wikipedia.org\/static\/images\/icons\/enwiki-25.svg) ![Wikipedia](https:\/\/en.wikipedia.org\/static\/images\/mobile\/copyright\/wikipedia-wordmark-en-25.svg) ![The Free Encyclopedia](https:\/\/en.wikipedia.org\/static\/images\/mobile\/copyright\/wikipedia-tagline-en-25.svg)](https:\/\/en.wikipedia.org\/wiki\/Main_Page)\n\n[Search](https:\/\/en.wikipedia.org\/wiki\/Special:Search \"Search Wikipedia [f]\")\n\nAppearance\n\n- [Donate](https:\/\/donate.wikimedia.org\/?wmf_source=donate&wmf_medium=sidebar&wmf_campaign=en.wikipedia.org&uselang=en)\n- [Create account](https:\/\/en.wikipedia.org\/w\/index.php?title=Special:CreateAccount&returnto=Abdominal+pain \"You are encouraged to create an account and log in; however, it is not mandatory\")\n- [Log in](https:\/\/en.wikipedia.org\/w\/index.php?title=Special:UserLogin&returnto=Abdominal+pain \"You're encouraged to log in; however, it's not mandatory. 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[o]\")\n\n## Contents\nmove to sidebar\n\nhide\n\n- [(Top)](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain)\n- [1 Signs and symptoms](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#Signs_and_symptoms)\n- [2 Causes](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#Causes)\n  Toggle Causes subsection\n  - [2\\.1 Acute abdomen](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#Acute_abdomen)\n  - [2\\.2 Surgical causes](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#Surgical_causes)\n    - [2\\.2.1 Inflammatory](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#Inflammatory)\n    - [2\\.2.2 Mechanical](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#Mechanical)\n    - [2\\.2.3 Vascular](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#Vascular)\n    - [2\\.2.4 Referred pain](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#Referred_pain)\n  - [2\\.3 Medical causes](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#Medical_causes)\n  - [2\\.4 Gynecological causes](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#Gynecological_causes)\n  - [2\\.5 By system](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#By_system)\n  - [2\\.6 By location](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#By_location)\n- [3 Mechanism](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#Mechanism)\n- [4 Diagnosis](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#Diagnosis)\n- [5 Management](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#Management)\n  Toggle Management subsection\n  - [5\\.1 Emergencies](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#Emergencies)\n- [6 Outlook](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#Outlook)\n- [7 Epidemiology](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#Epidemiology)\n- [8 Special populations](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#Special_populations)\n  Toggle Special populations subsection\n  - [8\\.1 Geriatrics](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#Geriatrics)\n  - [8\\.2 Pregnancy](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#Pregnancy)\n- [9 See also](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#See_also)\n- [10 References](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#References)\n- [11 Further reading](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#Further_reading)\n- [12 External links](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#External_links)\n\nToggle the table of contents\n\n# Abdominal pain\n52 languages\n\n- [العربية](https:\/\/ar.wikipedia.org\/wiki\/%D8%A3%D9%84%D9%85_%D8%A7%D9%84%D8%A8%D8%B7%D9%86 \"ألم البطن – Arabic\")\n- [تۆرکجه](https:\/\/azb.wikipedia.org\/wiki\/%D9%82%D8%A7%D8%B1%DB%8C%D9%86_%D8%A2%D8%BA%D8%B1%DB%8C%D8%B3%DB%8C \"قارین آغریسی – South Azerbaijani\")\n- [বাংলা](https:\/\/bn.wikipedia.org\/wiki\/%E0%A6%AA%E0%A7%87%E0%A6%9F%E0%A6%AC%E0%A7%8D%E0%A6%AF%E0%A6%A5%E0%A6%BE \"পেটব্যথা – Bangla\")\n- [Català](https:\/\/ca.wikipedia.org\/wiki\/Dolor_abdominal \"Dolor abdominal – Catalan\")\n- [Čeština](https:\/\/cs.wikipedia.org\/wiki\/Bolest_b%C5%99icha \"Bolest břicha – Czech\")\n- [Deutsch](https:\/\/de.wikipedia.org\/wiki\/Bauchschmerz \"Bauchschmerz – German\")\n- [ދިވެހިބަސް](https:\/\/dv.wikipedia.org\/wiki\/%DE%84%DE%A6%DE%82%DE%91%DE%AA%DE%8E%DE%A6%DE%87%DE%A8_%DE%83%DE%A8%DE%80%DE%AA%DE%82%DE%B0 \"ބަނޑުގައި ރިހުން – Divehi\")\n- [Esperanto](https:\/\/eo.wikipedia.org\/wiki\/Abdomena_doloro \"Abdomena doloro – Esperanto\")\n- [Español](https:\/\/es.wikipedia.org\/wiki\/Dolor_abdominal \"Dolor abdominal – Spanish\")\n- [Euskara](https:\/\/eu.wikipedia.org\/wiki\/Tripako_min \"Tripako min – Basque\")\n- [فارسی](https:\/\/fa.wikipedia.org\/wiki\/%D8%AF%D8%B1%D8%AF_%D8%B4%DA%A9%D9%85%DB%8C \"درد شکمی – Persian\")\n- [Suomi](https:\/\/fi.wikipedia.org\/wiki\/Vatsakipu \"Vatsakipu – Finnish\")\n- [Français](https:\/\/fr.wikipedia.org\/wiki\/Douleur_abdominale \"Douleur abdominale – French\")\n- [Avañe'ẽ](https:\/\/gn.wikipedia.org\/wiki\/Py%27arasy \"Py'arasy – Guarani\")\n- [Hausa](https:\/\/ha.wikipedia.org\/wiki\/Ciwon_ciki \"Ciwon ciki – Hausa\")\n- [עברית](https:\/\/he.wikipedia.org\/wiki\/%D7%9B%D7%90%D7%91_%D7%91%D7%98%D7%9F \"כאב בטן – Hebrew\")\n- [हिन्दी](https:\/\/hi.wikipedia.org\/wiki\/%E0%A4%AA%E0%A5%87%E0%A4%9F_%E0%A4%A6%E0%A4%B0%E0%A5%8D%E0%A4%A6 \"पेट दर्द – Hindi\")\n- [Հայերեն](https:\/\/hy.wikipedia.org\/wiki\/%D5%88%D6%80%D5%B8%D5%BE%D5%A1%D5%B5%D5%B6%D5%A1%D5%B5%D5%AB%D5%B6_%D6%81%D5%A1%D5%BE \"Որովայնային ցավ – Armenian\")\n- [Bahasa Indonesia](https:\/\/id.wikipedia.org\/wiki\/Mulas \"Mulas – Indonesian\")\n- [Ido](https:\/\/io.wikipedia.org\/wiki\/Gastralgio \"Gastralgio – Ido\")\n- [Italiano](https:\/\/it.wikipedia.org\/wiki\/Dolore_addominale \"Dolore addominale – Italian\")\n- [日本語](https:\/\/ja.wikipedia.org\/wiki\/%E8%85%B9%E7%97%9B \"腹痛 – Japanese\")\n- [한국어](https:\/\/ko.wikipedia.org\/wiki\/%EB%B3%B5%ED%86%B5 \"복통 – Korean\")\n- [کٲشُر](https:\/\/ks.wikipedia.org\/wiki\/%DB%8C%DA%88_%D8%AF%D9%8E%DA%AF \"یڈ دَگ – Kashmiri\")\n- [Македонски](https:\/\/mk.wikipedia.org\/wiki\/%D0%91%D0%BE%D0%BB%D0%BA%D0%B8_%D0%B2%D0%BE_%D1%81%D1%82%D0%BE%D0%BC%D0%B0%D0%BA%D0%BE%D1%82 \"Болки во стомакот – Macedonian\")\n- [मराठी](https:\/\/mr.wikipedia.org\/wiki\/%E0%A4%89%E0%A4%A6%E0%A4%B0%E0%A4%B6%E0%A5%82%E0%A4%B2 \"उदरशूल – Marathi\")\n- [Bahasa Melayu](https:\/\/ms.wikipedia.org\/wiki\/Sakit_abdomen \"Sakit abdomen – Malay\")\n- [Nederlands](https:\/\/nl.wikipedia.org\/wiki\/Buikpijn \"Buikpijn – Dutch\")\n- [ଓଡ଼ିଆ](https:\/\/or.wikipedia.org\/wiki\/%E0%AC%89%E0%AC%A6%E0%AC%B0_%E0%AC%AF%E0%AC%A8%E0%AD%8D%E0%AC%A4%E0%AD%8D%E0%AC%B0%E0%AC%A3%E0%AC%BE \"ଉଦର ଯନ୍ତ୍ରଣା – Odia\")\n- [Polski](https:\/\/pl.wikipedia.org\/wiki\/B%C3%B3l_brzucha \"Ból brzucha – Polish\")\n- [پښتو](https:\/\/ps.wikipedia.org\/wiki\/%D9%86%D8%B3%D8%AE%D9%88%DA%96%DB%8C \"نسخوږی – Pashto\")\n- [Português](https:\/\/pt.wikipedia.org\/wiki\/Dor_abdominal \"Dor abdominal – Portuguese\")\n- [Română](https:\/\/ro.wikipedia.org\/wiki\/Durere_abdominal%C4%83 \"Durere abdominală – Romanian\")\n- [Русский](https:\/\/ru.wikipedia.org\/wiki\/%D0%91%D0%BE%D0%BB%D0%B8_%D0%B2_%D0%BE%D0%B1%D0%BB%D0%B0%D1%81%D1%82%D0%B8_%D0%B6%D0%B8%D0%B2%D0%BE%D1%82%D0%B0_%D0%B8_%D1%82%D0%B0%D0%B7%D0%B0 \"Боли в области живота и таза – Russian\")\n- [سنڌي](https:\/\/sd.wikipedia.org\/wiki\/%D9%BE%D9%8A%D9%BD_%DB%BE_%D8%B3%D9%88%D8%B1 \"پيٽ ۾ سور – Sindhi\")\n- [Srpskohrvatski \/ српскохрватски](https:\/\/sh.wikipedia.org\/wiki\/Bol_u_trbuhu \"Bol u trbuhu – Serbo-Croatian\")\n- [Simple English](https:\/\/simple.wikipedia.org\/wiki\/Abdominal_pain \"Abdominal pain – Simple English\")\n- [Slovenščina](https:\/\/sl.wikipedia.org\/wiki\/Bole%C4%8Dina_v_trebuhu \"Bolečina v trebuhu – Slovenian\")\n- [Српски \/ srpski](https:\/\/sr.wikipedia.org\/wiki\/%D0%91%D0%BE%D0%BB_%D1%83_%D1%82%D1%80%D0%B1%D1%83%D1%85%D1%83 \"Бол у трбуху – Serbian\")\n- [Svenska](https:\/\/sv.wikipedia.org\/wiki\/Magsm%C3%A4rta \"Magsmärta – Swedish\")\n- [Kiswahili](https:\/\/sw.wikipedia.org\/wiki\/Maumivu_ya_tumbo \"Maumivu ya tumbo – Swahili\")\n- [தமிழ்](https:\/\/ta.wikipedia.org\/wiki\/%E0%AE%B5%E0%AE%AF%E0%AE%BF%E0%AE%B1%E0%AF%8D%E0%AE%B1%E0%AF%81_%E0%AE%B5%E0%AE%B2%E0%AE%BF \"வயிற்று வலி – Tamil\")\n- [తెలుగు](https:\/\/te.wikipedia.org\/wiki\/%E0%B0%95%E0%B0%A1%E0%B1%81%E0%B0%AA%E0%B1%81%E0%B0%A8%E0%B1%8A%E0%B0%AA%E0%B1%8D%E0%B0%AA%E0%B0%BF \"కడుపునొప్పి – Telugu\")\n- [ไทย](https:\/\/th.wikipedia.org\/wiki\/%E0%B8%9B%E0%B8%A7%E0%B8%94%E0%B8%97%E0%B9%89%E0%B8%AD%E0%B8%87 \"ปวดท้อง – Thai\")\n- [Tagalog](https:\/\/tl.wikipedia.org\/wiki\/Pananakit_ng_tiyan \"Pananakit ng tiyan – Tagalog\")\n- [Türkçe](https:\/\/tr.wikipedia.org\/wiki\/Kar%C4%B1n_a%C4%9Fr%C4%B1s%C4%B1 \"Karın ağrısı – Turkish\")\n- [Татарча \/ tatarça](https:\/\/tt.wikipedia.org\/wiki\/%D0%AD%D1%87_%D0%B0%D0%B2%D1%8B%D1%80%D1%82%D1%83%D0%BB%D0%B0%D1%80%D1%8B \"Эч авыртулары – Tatar\")\n- [Українська](https:\/\/uk.wikipedia.org\/wiki\/%D0%91%D1%96%D0%BB%D1%8C_%D1%83_%D0%B6%D0%B8%D0%B2%D0%BE%D1%82%D1%96 \"Біль у животі – Ukrainian\")\n- [Tiếng Việt](https:\/\/vi.wikipedia.org\/wiki\/%C4%90au_b%E1%BB%A5ng \"Đau bụng – Vietnamese\")\n- [Vahcuengh](https:\/\/za.wikipedia.org\/wiki\/Lajdungxin \"Lajdungxin – Zhuang\")\n- [粵語](https:\/\/zh-yue.wikipedia.org\/wiki\/%E8%82%9A%E7%97%9B \"肚痛 – Cantonese\")\n- [中文](https:\/\/zh.wikipedia.org\/wiki\/%E8%85%B9%E7%97%9B \"腹痛 – Chinese\")\n\n[Edit links](https:\/\/www.wikidata.org\/wiki\/Special:EntityPage\/Q183425#sitelinks-wikipedia \"Edit interlanguage links\")\n\n- [Article](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain \"View the content page [c]\")\n- [Talk](https:\/\/en.wikipedia.org\/wiki\/Talk:Abdominal_pain \"Discuss improvements to the content page [t]\")\n\nEnglish\n\n- [Read](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain)\n- [Edit](https:\/\/en.wikipedia.org\/w\/index.php?title=Abdominal_pain&action=edit \"Edit this 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Commons](https:\/\/commons.wikimedia.org\/wiki\/Category:Stomach_pain)\n- [Wikidata item](https:\/\/www.wikidata.org\/wiki\/Special:EntityPage\/Q183425 \"Structured data on this page hosted by Wikidata [g]\")\n\nAppearance\n\nmove to sidebar\n\nhide\n\nFrom Wikipedia, the free encyclopedia\n\nStomach aches\n\n\"Stomach ache\" redirects here. For the 2014 album by Frank Iero, see [Stomachaches (album)](https:\/\/en.wikipedia.org\/wiki\/Stomachaches_\\(album\\) \"Stomachaches (album)\").\n\nMedical condition\n\n| Abdominal pain |   |\n|---|---|\n| Other names | Stomach ache, tummy ache, belly ache, belly pain, gastralgia, stomach pain |\n| [![](https:\/\/upload.wikimedia.org\/wikipedia\/commons\/thumb\/f\/f0\/Gray1220.svg\/250px-Gray1220.svg.png)](https:\/\/en.wikipedia.org\/wiki\/File:Gray1220.svg) |   |\n| Abdominal pain can be characterized by the region it affects. |   |\n| [Specialty](https:\/\/en.wikipedia.org\/wiki\/Medical_specialty \"Medical specialty\") | [Gastroenterology](https:\/\/en.wikipedia.org\/wiki\/Gastroenterology \"Gastroenterology\"), [general surgery](https:\/\/en.wikipedia.org\/wiki\/General_surgery \"General surgery\") |\n| [Complications](https:\/\/en.wikipedia.org\/wiki\/Complication_\\(medicine\\) \"Complication (medicine)\") | [Anorexia](https:\/\/en.wikipedia.org\/wiki\/Anorexia_\\(symptom\\) \"Anorexia (symptom)\") |\n| [Causes](https:\/\/en.wikipedia.org\/wiki\/Cause_\\(medicine\\) \"Cause (medicine)\") | **Serious**: [Appendicitis](https:\/\/en.wikipedia.org\/wiki\/Appendicitis \"Appendicitis\"), perforated [stomach ulcer](https:\/\/en.wikipedia.org\/wiki\/Stomach_ulcer \"Stomach ulcer\"), [pancreatitis](https:\/\/en.wikipedia.org\/wiki\/Pancreatitis \"Pancreatitis\"), ruptured [diverticulitis](https:\/\/en.wikipedia.org\/wiki\/Diverticulitis \"Diverticulitis\"), [ovarian torsion](https:\/\/en.wikipedia.org\/wiki\/Ovarian_torsion \"Ovarian torsion\"), [volvulus](https:\/\/en.wikipedia.org\/wiki\/Volvulus \"Volvulus\"), ruptured [aortic aneurysm](https:\/\/en.wikipedia.org\/wiki\/Aortic_aneurysm \"Aortic aneurysm\"), [lacerated spleen](https:\/\/en.wikipedia.org\/wiki\/Lacerated_spleen \"Lacerated spleen\") or liver, [ischemic colitis](https:\/\/en.wikipedia.org\/wiki\/Ischemic_colitis \"Ischemic colitis\"), [ischaemic myocardial conditions](https:\/\/en.wikipedia.org\/w\/index.php?title=Ischaemic_myocardial_conditions&action=edit&redlink=1 \"Ischaemic myocardial conditions (page does not exist)\")[\\[1\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Stat2018-1) **Common**: [Gastroenteritis](https:\/\/en.wikipedia.org\/wiki\/Gastroenteritis \"Gastroenteritis\"), [irritable bowel syndrome](https:\/\/en.wikipedia.org\/wiki\/Irritable_bowel_syndrome \"Irritable bowel syndrome\")[\\[2\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Vin2014-2) |\n\n**Abdominal pain**, also known as a **stomach ache**, is a [symptom](https:\/\/en.wikipedia.org\/wiki\/Symptom \"Symptom\") associated with both non-serious and serious medical issues. Since the abdomen contains most of the body's vital organs, it can be an indicator of a wide variety of diseases. Given that, approaching the examination of a person and planning of a [differential diagnosis](https:\/\/en.wikipedia.org\/wiki\/Differential_diagnosis \"Differential diagnosis\") is extremely important.[\\[3\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Hopcroft2020-3)\n\nCommon causes of [pain](https:\/\/en.wikipedia.org\/wiki\/Pain \"Pain\") in the [abdomen](https:\/\/en.wikipedia.org\/wiki\/Abdomen \"Abdomen\") include [gastroenteritis](https:\/\/en.wikipedia.org\/wiki\/Gastroenteritis \"Gastroenteritis\") and [irritable bowel syndrome](https:\/\/en.wikipedia.org\/wiki\/Irritable_bowel_syndrome \"Irritable bowel syndrome\").[\\[3\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Hopcroft2020-3) About 15% of people have a more serious underlying condition such as [appendicitis](https:\/\/en.wikipedia.org\/wiki\/Appendicitis \"Appendicitis\"), leaking or ruptured [abdominal aortic aneurysm](https:\/\/en.wikipedia.org\/wiki\/Abdominal_aortic_aneurysm \"Abdominal aortic aneurysm\"), [diverticulitis](https:\/\/en.wikipedia.org\/wiki\/Diverticulitis \"Diverticulitis\"), or [ectopic pregnancy](https:\/\/en.wikipedia.org\/wiki\/Ectopic_pregnancy \"Ectopic pregnancy\").[\\[2\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Vin2014-2) In a third of cases, the exact cause is unclear.[\\[2\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Vin2014-2)\n\n## Signs and symptoms\n\\[[edit](https:\/\/en.wikipedia.org\/w\/index.php?title=Abdominal_pain&action=edit&section=1 \"Edit section: Signs and symptoms\")\\]\n\nThe onset of abdominal pain can be abrupt, quick, or gradual. Sudden onset pain happens in a split second. Rapidly onset pain starts mild and gets worse over the next few minutes. Pain that gradually intensifies only after several hours or even days has passed is referred to as gradual onset pain.[\\[4\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Sherman_1990_r770-4)\n\nOne can describe abdominal pain as either continuous or sporadic and as [cramping](https:\/\/en.wikipedia.org\/wiki\/Cramp \"Cramp\"), dull, or aching. The characteristic of cramping abdominal pain is that it comes in brief waves, builds to a peak, and then abruptly stops for a period during which there is no more pain. The pain flares up and off periodically. The most common cause of persistent dull or aching abdominal pain is edema or distention of the wall of a hollow viscus. A dull or aching pain may also be felt due to a stretch in the liver and spleen capsules.[\\[4\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Sherman_1990_r770-4)\n\n## Causes\n\\[[edit](https:\/\/en.wikipedia.org\/w\/index.php?title=Abdominal_pain&action=edit&section=2 \"Edit section: Causes\")\\]\n\nThe most frequent reasons for abdominal pain are [gastroenteritis](https:\/\/en.wikipedia.org\/wiki\/Gastroenteritis \"Gastroenteritis\") (13%), [irritable bowel syndrome](https:\/\/en.wikipedia.org\/wiki\/Irritable_bowel_syndrome \"Irritable bowel syndrome\") (8%), urinary tract problems (5%), [inflammation of the stomach](https:\/\/en.wikipedia.org\/wiki\/Gastritis \"Gastritis\") (5%) and [constipation](https:\/\/en.wikipedia.org\/wiki\/Constipation \"Constipation\") (5%). In about 30% of cases, the cause is not determined. About 10% of cases have a more serious cause including gallbladder ([gallstones](https:\/\/en.wikipedia.org\/wiki\/Gallstone \"Gallstone\") or [biliary dyskinesia](https:\/\/en.wikipedia.org\/wiki\/Biliary_dyskinesia \"Biliary dyskinesia\")) or [pancreas](https:\/\/en.wikipedia.org\/wiki\/Pancreas \"Pancreas\") problems (4%), [diverticulitis](https:\/\/en.wikipedia.org\/wiki\/Diverticulitis \"Diverticulitis\") (3%), [appendicitis](https:\/\/en.wikipedia.org\/wiki\/Appendicitis \"Appendicitis\") (2%) and [cancer](https:\/\/en.wikipedia.org\/wiki\/Cancer \"Cancer\") (1%).[\\[2\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Vin2014-2) More common in those who are older, [ischemic colitis](https:\/\/en.wikipedia.org\/wiki\/Ischemic_colitis \"Ischemic colitis\"),[\\[5\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-5) [mesenteric ischemia](https:\/\/en.wikipedia.org\/wiki\/Mesenteric_ischemia \"Mesenteric ischemia\"), and [abdominal aortic aneurysms](https:\/\/en.wikipedia.org\/wiki\/Abdominal_aortic_aneurysm \"Abdominal aortic aneurysm\") are other serious causes.[\\[6\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Spangler_2014-6)\n\n### Acute abdomen\n\\[[edit](https:\/\/en.wikipedia.org\/w\/index.php?title=Abdominal_pain&action=edit&section=3 \"Edit section: Acute abdomen\")\\]\n\n[Acute abdomen](https:\/\/en.wikipedia.org\/wiki\/Acute_abdomen \"Acute abdomen\") is a condition where there is a sudden onset of severe abdominal pain requiring immediate recognition and management of the underlying cause.[\\[7\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-aa-7) The underlying cause may involve infection, [inflammation](https:\/\/en.wikipedia.org\/wiki\/Inflammation \"Inflammation\"), [vascular occlusion](https:\/\/en.wikipedia.org\/wiki\/Vascular_occlusion \"Vascular occlusion\") or bowel obstruction.[\\[7\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-aa-7)\n\nThe pain may elicit [nausea](https:\/\/en.wikipedia.org\/wiki\/Nausea \"Nausea\") and [vomiting](https:\/\/en.wikipedia.org\/wiki\/Vomiting \"Vomiting\"), [abdominal distention](https:\/\/en.wikipedia.org\/wiki\/Abdominal_distention \"Abdominal distention\"), [fever](https:\/\/en.wikipedia.org\/wiki\/Fever \"Fever\") and signs of [shock](https:\/\/en.wikipedia.org\/wiki\/Shock_\\(circulatory\\) \"Shock (circulatory)\").[\\[7\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-aa-7) A common condition associated with acute abdominal pain is [appendicitis](https:\/\/en.wikipedia.org\/wiki\/Appendicitis \"Appendicitis\").[\\[8\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-8) Here is a list of acute abdomen causes:\n\n|   |   |\n|---|---|\n| Surgical causes \\[[edit](https:\/\/en.wikipedia.org\/w\/index.php?title=Abdominal_pain&action=edit&section=4 \"Edit section: Surgical causes\")\\] | Source:[\\[7\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-aa-7) Inflammatory \\[[edit](https:\/\/en.wikipedia.org\/w\/index.php?title=Abdominal_pain&action=edit&section=5 \"Edit section: Inflammatory\")\\] Infections such as [appendicitis](https:\/\/en.wikipedia.org\/wiki\/Appendicitis \"Appendicitis\"), [cholecystitis](https:\/\/en.wikipedia.org\/wiki\/Cholecystitis \"Cholecystitis\"), [pancreatitis](https:\/\/en.wikipedia.org\/wiki\/Pancreatitis \"Pancreatitis\"), [pyelonephritis](https:\/\/en.wikipedia.org\/wiki\/Pyelonephritis \"Pyelonephritis\"), [Peritonitis](https:\/\/en.wikipedia.org\/wiki\/Peritonitis \"Peritonitis\"), [pelvic inflammatory disease](https:\/\/en.wikipedia.org\/wiki\/Pelvic_inflammatory_disease \"Pelvic inflammatory disease\"), [hepatitis](https:\/\/en.wikipedia.org\/wiki\/Hepatitis \"Hepatitis\"), [mesenteric adenitis](https:\/\/en.wikipedia.org\/wiki\/Mesenteric_adenitis \"Mesenteric adenitis\"), or a subdiaphragmatic [abscess](https:\/\/en.wikipedia.org\/wiki\/Abscess \"Abscess\"). [Perforation](https:\/\/en.wikipedia.org\/wiki\/Gastrointestinal_perforation \"Gastrointestinal perforation\") of a [peptic ulcer](https:\/\/en.wikipedia.org\/wiki\/Peptic_ulcer \"Peptic ulcer\"), a [diverticulum](https:\/\/en.wikipedia.org\/wiki\/Diverticulitis \"Diverticulitis\"), or the [caecum](https:\/\/en.wikipedia.org\/wiki\/Caecum \"Caecum\"). Complications of [inflammatory bowel disease](https:\/\/en.wikipedia.org\/wiki\/Inflammatory_bowel_disease \"Inflammatory bowel disease\"), such as [Crohn's disease](https:\/\/en.wikipedia.org\/wiki\/Crohn%27s_disease \"Crohn's disease\") or [ulcerative colitis](https:\/\/en.wikipedia.org\/wiki\/Ulcerative_colitis \"Ulcerative colitis\"). Mechanical \\[[edit](https:\/\/en.wikipedia.org\/w\/index.php?title=Abdominal_pain&action=edit&section=6 \"Edit section: Mechanical\")\\] [Small bowel](https:\/\/en.wikipedia.org\/wiki\/Small_bowel \"Small bowel\") [obstruction](https:\/\/en.wikipedia.org\/wiki\/Bowel_obstruction \"Bowel obstruction\") secondary to adhesions caused by previous surgeries, [intussusception](https:\/\/en.wikipedia.org\/wiki\/Intussusception_\\(medical_disorder\\) \"Intussusception (medical disorder)\"), [hernias](https:\/\/en.wikipedia.org\/wiki\/Hernia \"Hernia\"), benign or malignant [neoplasms](https:\/\/en.wikipedia.org\/wiki\/Neoplasia \"Neoplasia\"). [Large bowel](https:\/\/en.wikipedia.org\/wiki\/Large_bowel \"Large bowel\") [obstruction](https:\/\/en.wikipedia.org\/wiki\/Bowel_obstruction \"Bowel obstruction\") caused by [colorectal cancer](https:\/\/en.wikipedia.org\/wiki\/Colorectal_cancer \"Colorectal cancer\"), [inflammatory bowel disease](https:\/\/en.wikipedia.org\/wiki\/Inflammatory_bowel_disease \"Inflammatory bowel disease\"), [volvulus](https:\/\/en.wikipedia.org\/wiki\/Volvulus \"Volvulus\"), [fecal impaction](https:\/\/en.wikipedia.org\/wiki\/Fecal_impaction \"Fecal impaction\"), or [hernia](https:\/\/en.wikipedia.org\/wiki\/Hernia \"Hernia\"). Vascular \\[[edit](https:\/\/en.wikipedia.org\/w\/index.php?title=Abdominal_pain&action=edit&section=7 \"Edit section: Vascular\")\\] occlusive [intestinal ischemia](https:\/\/en.wikipedia.org\/wiki\/Intestinal_ischemia \"Intestinal ischemia\"), usually caused by [thromboembolism](https:\/\/en.wikipedia.org\/wiki\/Thromboembolism \"Thromboembolism\") of the [superior Mesenteric artery.](https:\/\/en.wikipedia.org\/wiki\/Superior_mesenteric_artery \"Superior mesenteric artery\") [Referred pain](https:\/\/en.wikipedia.org\/wiki\/Referred_pain \"Referred pain\") \\[[edit](https:\/\/en.wikipedia.org\/w\/index.php?title=Abdominal_pain&action=edit&section=8 \"Edit section: Referred pain\")\\] Source:[\\[9\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-9) Viscero-visceral referral: happens when one organ with afferent nerves close to another organ is sensitized or inflamed (in this case any of the abdominal viscera)[\\[10\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-10) Viscero-somatic referral: any pain in the viscera that causes pain in the muscle, bone, and skin (of the abdomen in case of abdominal pain) Somatic-visceral referral: pain in the skin, muscles, and bone that causes referred pain in the viscera (of the abdomen such as the stomach, kidneys, bladder, etc.) |\n| Medical causes \\[[edit](https:\/\/en.wikipedia.org\/w\/index.php?title=Abdominal_pain&action=edit&section=9 \"Edit section: Medical causes\")\\] | Source:[\\[7\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-aa-7)[Acute pancreatitis](https:\/\/en.wikipedia.org\/wiki\/Acute_pancreatitis \"Acute pancreatitis\").[Sickle cell anemia](https:\/\/en.wikipedia.org\/wiki\/Sickle_cell_disease \"Sickle cell disease\").[Diabetic ketoacidosis](https:\/\/en.wikipedia.org\/wiki\/Diabetic_ketoacidosis \"Diabetic ketoacidosis\") (DKA).[Adrenal crisis](https:\/\/en.wikipedia.org\/wiki\/Adrenal_crisis \"Adrenal crisis\").[Pyelonephritis](https:\/\/en.wikipedia.org\/wiki\/Pyelonephritis \"Pyelonephritis\").[Lead poisoning](https:\/\/en.wikipedia.org\/wiki\/Lead_poisoning \"Lead poisoning\").[Familial Mediterranean fever](https:\/\/en.wikipedia.org\/wiki\/Familial_Mediterranean_fever \"Familial Mediterranean fever\") (FMF). |\n| Gynecological causes \\[[edit](https:\/\/en.wikipedia.org\/w\/index.php?title=Abdominal_pain&action=edit&section=10 \"Edit section: Gynecological causes\")\\] | Source:[\\[11\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-11)[Pelvic inflammatory disease](https:\/\/en.wikipedia.org\/wiki\/Pelvic_inflammatory_disease \"Pelvic inflammatory disease\") (PID) and abscess.[Ectopic pregnancy](https:\/\/en.wikipedia.org\/wiki\/Ectopic_pregnancy \"Ectopic pregnancy\").Hemorrhagic [ovarian cyst](https:\/\/en.wikipedia.org\/wiki\/Ovarian_cyst \"Ovarian cyst\").Adnexal or [ovarian torsion](https:\/\/en.wikipedia.org\/wiki\/Ovarian_torsion \"Ovarian torsion\"). |\n\n### By system\n\\[[edit](https:\/\/en.wikipedia.org\/w\/index.php?title=Abdominal_pain&action=edit&section=11 \"Edit section: By system\")\\]\n\nA more extensive list includes the following:\\[*[citation needed](https:\/\/en.wikipedia.org\/wiki\/Wikipedia:Citation_needed \"Wikipedia:Citation needed\")*\\]\n\n- Gastrointestinal\n  - GI tract\n    - Inflammatory: [gastroenteritis](https:\/\/en.wikipedia.org\/wiki\/Gastroenteritis \"Gastroenteritis\"), [appendicitis](https:\/\/en.wikipedia.org\/wiki\/Appendicitis \"Appendicitis\"), [gastritis](https:\/\/en.wikipedia.org\/wiki\/Gastritis \"Gastritis\"), [esophagitis](https:\/\/en.wikipedia.org\/wiki\/Esophagitis \"Esophagitis\"), [diverticulitis](https:\/\/en.wikipedia.org\/wiki\/Diverticulitis \"Diverticulitis\"), [Crohn's disease](https:\/\/en.wikipedia.org\/wiki\/Crohn%27s_disease \"Crohn's disease\"), [ulcerative colitis](https:\/\/en.wikipedia.org\/wiki\/Ulcerative_colitis \"Ulcerative colitis\"), [microscopic colitis](https:\/\/en.wikipedia.org\/wiki\/Microscopic_colitis \"Microscopic colitis\")\n    - Obstruction: [hernia](https:\/\/en.wikipedia.org\/wiki\/Hernia \"Hernia\"), [intussusception](https:\/\/en.wikipedia.org\/wiki\/Intussusception_\\(medical_disorder\\) \"Intussusception (medical disorder)\"), [volvulus](https:\/\/en.wikipedia.org\/wiki\/Volvulus \"Volvulus\"), post-surgical [adhesions](https:\/\/en.wikipedia.org\/wiki\/Adhesions \"Adhesions\"), [tumors](https:\/\/en.wikipedia.org\/wiki\/Tumor \"Tumor\"), severe [constipation](https:\/\/en.wikipedia.org\/wiki\/Constipation \"Constipation\"), [hemorrhoids](https:\/\/en.wikipedia.org\/wiki\/Hemorrhoids \"Hemorrhoids\")\n    - Vascular: [embolism](https:\/\/en.wikipedia.org\/wiki\/Embolism \"Embolism\"), [thrombosis](https:\/\/en.wikipedia.org\/wiki\/Thrombosis \"Thrombosis\"), [hemorrhage](https:\/\/en.wikipedia.org\/wiki\/Hemorrhage \"Hemorrhage\"), [sickle cell disease](https:\/\/en.wikipedia.org\/wiki\/Sickle_cell_disease \"Sickle cell disease\"), [abdominal angina](https:\/\/en.wikipedia.org\/wiki\/Abdominal_angina \"Abdominal angina\"), blood vessel compression (such as celiac artery compression syndrome), [superior mesenteric artery syndrome](https:\/\/en.wikipedia.org\/wiki\/Superior_mesenteric_artery_syndrome \"Superior mesenteric artery syndrome\"), [postural orthostatic tachycardia syndrome](https:\/\/en.wikipedia.org\/wiki\/Postural_orthostatic_tachycardia_syndrome \"Postural orthostatic tachycardia syndrome\")\n    - [Digestive](https:\/\/en.wikipedia.org\/wiki\/Digestion \"Digestion\"): [peptic ulcer](https:\/\/en.wikipedia.org\/wiki\/Peptic_ulcer \"Peptic ulcer\"), [lactose intolerance](https:\/\/en.wikipedia.org\/wiki\/Lactose_intolerance \"Lactose intolerance\"), [celiac disease](https:\/\/en.wikipedia.org\/wiki\/Coeliac_disease \"Coeliac disease\"), [food allergies](https:\/\/en.wikipedia.org\/wiki\/Food_allergies \"Food allergies\"), [indigestion](https:\/\/en.wikipedia.org\/wiki\/Indigestion \"Indigestion\")\n  - Glands\n    - Bile system\n      - Inflammatory: [cholecystitis](https:\/\/en.wikipedia.org\/wiki\/Cholecystitis \"Cholecystitis\"), [cholangitis](https:\/\/en.wikipedia.org\/wiki\/Cholangitis \"Cholangitis\")\n      - Obstruction: [cholelithiasis](https:\/\/en.wikipedia.org\/wiki\/Cholelithiasis \"Cholelithiasis\")\n    - Liver\n      - Inflammatory: [hepatitis](https:\/\/en.wikipedia.org\/wiki\/Hepatitis \"Hepatitis\"), [liver abscess](https:\/\/en.wikipedia.org\/wiki\/Liver_abscess \"Liver abscess\")\n    - Pancreatic\n      - Inflammatory: [pancreatitis](https:\/\/en.wikipedia.org\/wiki\/Pancreatitis \"Pancreatitis\")\n- Renal and urological\n  - Inflammation: [pyelonephritis](https:\/\/en.wikipedia.org\/wiki\/Pyelonephritis \"Pyelonephritis\"), [bladder infection](https:\/\/en.wikipedia.org\/wiki\/Cystitis \"Cystitis\")\n  - Obstruction: [kidney stones](https:\/\/en.wikipedia.org\/wiki\/Nephrolithiasis \"Nephrolithiasis\"), [urolithiasis](https:\/\/en.wikipedia.org\/wiki\/Urolithiasis \"Urolithiasis\"), [urinary retention](https:\/\/en.wikipedia.org\/wiki\/Urinary_retention \"Urinary retention\")\n  - Vascular: [left renal vein entrapment](https:\/\/en.wikipedia.org\/wiki\/Left_renal_vein_entrapment \"Left renal vein entrapment\")\n- Gynaecological or obstetric\n  - Inflammatory: [pelvic inflammatory disease](https:\/\/en.wikipedia.org\/wiki\/Pelvic_inflammatory_disease \"Pelvic inflammatory disease\")\n  - Mechanical: [ovarian torsion](https:\/\/en.wikipedia.org\/wiki\/Ovarian_torsion \"Ovarian torsion\")\n  - Endocrinological: [menstruation](https:\/\/en.wikipedia.org\/wiki\/Menstruation \"Menstruation\"), [Mittelschmerz](https:\/\/en.wikipedia.org\/wiki\/Mittelschmerz \"Mittelschmerz\")\n  - Tumors: [endometriosis](https:\/\/en.wikipedia.org\/wiki\/Endometriosis \"Endometriosis\"), [fibroids](https:\/\/en.wikipedia.org\/wiki\/Fibroma \"Fibroma\"), [ovarian cyst](https:\/\/en.wikipedia.org\/wiki\/Ovarian_cyst \"Ovarian cyst\"), [ovarian cancer](https:\/\/en.wikipedia.org\/wiki\/Ovarian_cancer \"Ovarian cancer\")\n  - Pregnancy: ruptured [ectopic pregnancy](https:\/\/en.wikipedia.org\/wiki\/Ectopic_pregnancy \"Ectopic pregnancy\"), [threatened abortion](https:\/\/en.wikipedia.org\/wiki\/Threatened_abortion \"Threatened abortion\")\n- [Abdominal wall](https:\/\/en.wikipedia.org\/wiki\/Abdominal_wall \"Abdominal wall\")\n  - muscle strain or trauma\n  - muscular infection\n  - [neurogenic](https:\/\/en.wikipedia.org\/wiki\/Neurogenic \"Neurogenic\") pain: [herpes zoster](https:\/\/en.wikipedia.org\/wiki\/Herpes_zoster \"Herpes zoster\"), [radiculitis](https:\/\/en.wikipedia.org\/wiki\/Radiculitis \"Radiculitis\") in [Lyme disease](https:\/\/en.wikipedia.org\/wiki\/Lyme_disease \"Lyme disease\"), [abdominal cutaneous nerve entrapment syndrome](https:\/\/en.wikipedia.org\/wiki\/Anterior_cutaneous_nerve_entrapment_syndrome \"Anterior cutaneous nerve entrapment syndrome\") (ACNES), [tabes dorsalis](https:\/\/en.wikipedia.org\/wiki\/Tabes_dorsalis \"Tabes dorsalis\")\n- [Referred pain](https:\/\/en.wikipedia.org\/wiki\/Referred_pain \"Referred pain\")\n  - from the [thorax](https:\/\/en.wikipedia.org\/wiki\/Thorax \"Thorax\"): [pneumonia](https:\/\/en.wikipedia.org\/wiki\/Pneumonia \"Pneumonia\"), [pulmonary embolism](https:\/\/en.wikipedia.org\/wiki\/Pulmonary_embolism \"Pulmonary embolism\"), [ischemic heart disease](https:\/\/en.wikipedia.org\/wiki\/Ischemic_heart_disease \"Ischemic heart disease\"), [pericarditis](https:\/\/en.wikipedia.org\/wiki\/Pericarditis \"Pericarditis\")\n  - from the [spine](https:\/\/en.wikipedia.org\/wiki\/Vertebral_column \"Vertebral column\"): [radiculitis](https:\/\/en.wikipedia.org\/wiki\/Radiculitis \"Radiculitis\")\n  - from the [genitals](https:\/\/en.wikipedia.org\/wiki\/Genitals \"Genitals\"): [testicular torsion](https:\/\/en.wikipedia.org\/wiki\/Testicular_torsion \"Testicular torsion\")\n- [Metabolic disturbance](https:\/\/en.wikipedia.org\/wiki\/Metabolic_disturbance \"Metabolic disturbance\")\n  - [uremia](https:\/\/en.wikipedia.org\/wiki\/Uremia \"Uremia\"), [diabetic ketoacidosis](https:\/\/en.wikipedia.org\/wiki\/Diabetic_ketoacidosis \"Diabetic ketoacidosis\"), [porphyria](https:\/\/en.wikipedia.org\/wiki\/Porphyria \"Porphyria\"), [C1-esterase inhibitor deficiency](https:\/\/en.wikipedia.org\/wiki\/C1-esterase_inhibitor_deficiency \"C1-esterase inhibitor deficiency\"), adrenal insufficiency, [lead poisoning](https:\/\/en.wikipedia.org\/wiki\/Lead_poisoning \"Lead poisoning\"), [black widow spider](https:\/\/en.wikipedia.org\/wiki\/Latrodectus \"Latrodectus\") bite, [narcotic](https:\/\/en.wikipedia.org\/wiki\/Narcotic \"Narcotic\") [withdrawal](https:\/\/en.wikipedia.org\/wiki\/Drug_withdrawal \"Drug withdrawal\")\n- Blood vessels\n  - [aortic dissection](https:\/\/en.wikipedia.org\/wiki\/Aortic_dissection \"Aortic dissection\"), [abdominal aortic aneurysm](https:\/\/en.wikipedia.org\/wiki\/Abdominal_aortic_aneurysm \"Abdominal aortic aneurysm\")\n- Immune system\n  - [sarcoidosis](https:\/\/en.wikipedia.org\/wiki\/Sarcoidosis \"Sarcoidosis\")\n  - [vasculitis](https:\/\/en.wikipedia.org\/wiki\/Vasculitis \"Vasculitis\")\n  - [familial Mediterranean fever](https:\/\/en.wikipedia.org\/wiki\/Familial_Mediterranean_fever \"Familial Mediterranean fever\")\n- Idiopathic\n  - [irritable bowel syndrome](https:\/\/en.wikipedia.org\/wiki\/Irritable_bowel_syndrome \"Irritable bowel syndrome\") (IBS) (affecting up to 20% of the population, IBS is the most common cause of recurrent and intermittent abdominal pain)\n\n### By location\n\\[[edit](https:\/\/en.wikipedia.org\/w\/index.php?title=Abdominal_pain&action=edit&section=12 \"Edit section: By location\")\\]\n\nThe location of abdominal pain can provide information about what may be causing the pain. The abdomen can be divided into four regions called quadrants. Locations and associated conditions include:[\\[12\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-12)[\\[13\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-13)\n\n- Diffuse\n  - [Peritonitis](https:\/\/en.wikipedia.org\/wiki\/Peritonitis \"Peritonitis\")\n  - Vascular: [mesenteric ischemia](https:\/\/en.wikipedia.org\/wiki\/Mesenteric_ischemia \"Mesenteric ischemia\"), [ischemic colitis](https:\/\/en.wikipedia.org\/wiki\/Ischemic_colitis \"Ischemic colitis\"), [Henoch-Schonlein purpura](https:\/\/en.wikipedia.org\/wiki\/Henoch%E2%80%93Sch%C3%B6nlein_purpura \"Henoch–Schönlein purpura\"), [sickle cell disease](https:\/\/en.wikipedia.org\/wiki\/Sickle_cell_disease \"Sickle cell disease\"), [systemic lupus erythematosus](https:\/\/en.wikipedia.org\/wiki\/Systemic_lupus_erythematosus \"Systemic lupus erythematosus\"), [polyarteritis nodosa](https:\/\/en.wikipedia.org\/wiki\/Polyarteritis_nodosa \"Polyarteritis nodosa\")\n  - Small [bowel obstruction](https:\/\/en.wikipedia.org\/wiki\/Bowel_obstruction \"Bowel obstruction\")\n  - [Irritable bowel syndrome](https:\/\/en.wikipedia.org\/wiki\/Irritable_bowel_syndrome \"Irritable bowel syndrome\")\n  - [Metabolic disorders](https:\/\/en.wikipedia.org\/wiki\/Metabolic_disorder \"Metabolic disorder\"): [ketoacidosis](https:\/\/en.wikipedia.org\/wiki\/Ketoacidosis \"Ketoacidosis\"), [porphyria](https:\/\/en.wikipedia.org\/wiki\/Porphyria \"Porphyria\"), [familial Mediterranean fever](https:\/\/en.wikipedia.org\/wiki\/Familial_Mediterranean_fever \"Familial Mediterranean fever\"), [adrenal crisis](https:\/\/en.wikipedia.org\/wiki\/Adrenal_crisis \"Adrenal crisis\")\n- Epigastric\n  - Heart: [myocardial infarction](https:\/\/en.wikipedia.org\/wiki\/Myocardial_infarction \"Myocardial infarction\"), [pericarditis](https:\/\/en.wikipedia.org\/wiki\/Pericarditis \"Pericarditis\")\n  - Stomach: [gastritis](https:\/\/en.wikipedia.org\/wiki\/Gastritis \"Gastritis\"), [stomach ulcer](https:\/\/en.wikipedia.org\/wiki\/Stomach_ulcer \"Stomach ulcer\"), [stomach cancer](https:\/\/en.wikipedia.org\/wiki\/Stomach_cancer \"Stomach cancer\")\n  - Pancreas: [pancreatitis](https:\/\/en.wikipedia.org\/wiki\/Pancreatitis \"Pancreatitis\"), [pancreatic cancer](https:\/\/en.wikipedia.org\/wiki\/Pancreatic_cancer \"Pancreatic cancer\")\n  - Intestinal: [duodenal ulcer](https:\/\/en.wikipedia.org\/wiki\/Peptic_ulcer_disease \"Peptic ulcer disease\"), [diverticulitis](https:\/\/en.wikipedia.org\/wiki\/Diverticulitis \"Diverticulitis\"), [appendicitis](https:\/\/en.wikipedia.org\/wiki\/Appendicitis \"Appendicitis\")\n- Right upper quadrant\n  - Liver: [hepatomegaly](https:\/\/en.wikipedia.org\/wiki\/Hepatomegaly \"Hepatomegaly\"), [fatty liver](https:\/\/en.wikipedia.org\/wiki\/Fatty_liver \"Fatty liver\"), [hepatitis](https:\/\/en.wikipedia.org\/wiki\/Hepatitis \"Hepatitis\"), [liver cancer](https:\/\/en.wikipedia.org\/wiki\/Liver_cancer \"Liver cancer\"), [abscess](https:\/\/en.wikipedia.org\/wiki\/Abscess \"Abscess\")\n  - Gallbladder and biliary tract: [inflammation](https:\/\/en.wikipedia.org\/wiki\/Cholecystitis \"Cholecystitis\"), [gallstones](https:\/\/en.wikipedia.org\/wiki\/Gallstone \"Gallstone\"), [worm infection](https:\/\/en.wikipedia.org\/wiki\/Helminthiasis \"Helminthiasis\"), [cholangitis](https:\/\/en.wikipedia.org\/wiki\/Cholangitis \"Cholangitis\")\n  - Colon: [bowel obstruction](https:\/\/en.wikipedia.org\/wiki\/Bowel_obstruction \"Bowel obstruction\"), functional disorders, [gas accumulation](https:\/\/en.wikipedia.org\/wiki\/Bloating \"Bloating\"), [spasm](https:\/\/en.wikipedia.org\/wiki\/Spasm \"Spasm\"), inflammation, [colon cancer](https:\/\/en.wikipedia.org\/wiki\/Colon_cancer \"Colon cancer\")\n  - Other: [pneumonia](https:\/\/en.wikipedia.org\/wiki\/Pneumonia \"Pneumonia\"), [Fitz-Hugh-Curtis syndrome](https:\/\/en.wikipedia.org\/wiki\/Fitz-Hugh%E2%80%93Curtis_syndrome \"Fitz-Hugh–Curtis syndrome\")\n- Left upper quadrant\n  - [Splenomegaly](https:\/\/en.wikipedia.org\/wiki\/Splenomegaly \"Splenomegaly\")\n  - Colon: [bowel obstruction](https:\/\/en.wikipedia.org\/wiki\/Bowel_obstruction \"Bowel obstruction\"), functional disorders, gas accumulation, spasm, inflammation, colon cancer\n- Peri-umbilical (the area around the umbilicus, i.e., the belly button)\n  - [Appendicitis](https:\/\/en.wikipedia.org\/wiki\/Appendicitis \"Appendicitis\")\n  - [Pancreatitis](https:\/\/en.wikipedia.org\/wiki\/Pancreatitis \"Pancreatitis\")\n  - [Inferior myocardial infarction](https:\/\/en.wikipedia.org\/wiki\/Myocardial_infarction \"Myocardial infarction\")\n  - [Peptic ulcer](https:\/\/en.wikipedia.org\/wiki\/Peptic_ulcer_disease \"Peptic ulcer disease\")\n  - [Diabetic ketoacidosis](https:\/\/en.wikipedia.org\/wiki\/Diabetic_ketoacidosis \"Diabetic ketoacidosis\")\n  - Vascular: [aortic dissection](https:\/\/en.wikipedia.org\/wiki\/Aortic_dissection \"Aortic dissection\"), aortic rupture\n  - Bowel: [mesenteric ischemia](https:\/\/en.wikipedia.org\/wiki\/Mesenteric_ischemia \"Mesenteric ischemia\"), [Celiac disease](https:\/\/en.wikipedia.org\/wiki\/Coeliac_disease \"Coeliac disease\"), inflammation, intestinal spasm, functional disorders, [small bowel obstruction](https:\/\/en.wikipedia.org\/wiki\/Bowel_obstruction \"Bowel obstruction\")\n- Lower abdominal pain\n  - [Diarrhea](https:\/\/en.wikipedia.org\/wiki\/Diarrhea \"Diarrhea\")\n  - [Colitis](https:\/\/en.wikipedia.org\/wiki\/Colitis \"Colitis\")\n  - [Crohn's](https:\/\/en.wikipedia.org\/wiki\/Crohn%27s_disease \"Crohn's disease\")\n  - [Dysentery](https:\/\/en.wikipedia.org\/wiki\/Dysentery \"Dysentery\")\n  - [Hernia](https:\/\/en.wikipedia.org\/wiki\/Hernia \"Hernia\")\n- Right lower quadrant\n  - Colon: [intussusception](https:\/\/en.wikipedia.org\/wiki\/Intussusception_\\(medical_disorder\\) \"Intussusception (medical disorder)\"), [bowel obstruction](https:\/\/en.wikipedia.org\/wiki\/Bowel_obstruction \"Bowel obstruction\"), [appendicitis](https:\/\/en.wikipedia.org\/wiki\/Appendicitis \"Appendicitis\") ([McBurney's point](https:\/\/en.wikipedia.org\/wiki\/McBurney%27s_point \"McBurney's point\"))\n  - Renal: [kidney stone](https:\/\/en.wikipedia.org\/wiki\/Kidney_stone_disease \"Kidney stone disease\") (nephrolithiasis), [pyelonephritis](https:\/\/en.wikipedia.org\/wiki\/Pyelonephritis \"Pyelonephritis\")\n  - Pelvic: [cystitis](https:\/\/en.wikipedia.org\/wiki\/Cystitis \"Cystitis\"), [bladder stone](https:\/\/en.wikipedia.org\/wiki\/Bladder_stone \"Bladder stone\"), [bladder cancer](https:\/\/en.wikipedia.org\/wiki\/Bladder_cancer \"Bladder cancer\"), [pelvic inflammatory disease](https:\/\/en.wikipedia.org\/wiki\/Pelvic_inflammatory_disease \"Pelvic inflammatory disease\"), pelvic pain syndrome\n  - Gynecologic: [endometriosis](https:\/\/en.wikipedia.org\/wiki\/Endometriosis \"Endometriosis\"), intrauterine [pregnancy](https:\/\/en.wikipedia.org\/wiki\/Pregnancy \"Pregnancy\"), [ectopic pregnancy](https:\/\/en.wikipedia.org\/wiki\/Ectopic_pregnancy \"Ectopic pregnancy\"), [ovarian cyst](https:\/\/en.wikipedia.org\/wiki\/Ovarian_cyst \"Ovarian cyst\"), [ovarian torsion](https:\/\/en.wikipedia.org\/wiki\/Ovarian_torsion \"Ovarian torsion\"), fibroid ([leiomyoma](https:\/\/en.wikipedia.org\/wiki\/Leiomyoma \"Leiomyoma\")), [abscess](https:\/\/en.wikipedia.org\/wiki\/Abscess \"Abscess\"), [ovarian cancer](https:\/\/en.wikipedia.org\/wiki\/Ovarian_cancer \"Ovarian cancer\"), [endometrial cancer](https:\/\/en.wikipedia.org\/wiki\/Endometrial_cancer \"Endometrial cancer\")\n- Left lower quadrant\n  - Bowel: [diverticulitis](https:\/\/en.wikipedia.org\/wiki\/Diverticulitis \"Diverticulitis\"), [sigmoid colon volvulus](https:\/\/en.wikipedia.org\/wiki\/Sigmoid_colon_volvulus \"Sigmoid colon volvulus\"), [bowel obstruction](https:\/\/en.wikipedia.org\/wiki\/Bowel_obstruction \"Bowel obstruction\"), gas accumulation, [Toxic megacolon](https:\/\/en.wikipedia.org\/wiki\/Toxic_megacolon \"Toxic megacolon\")\n- Right [low back pain](https:\/\/en.wikipedia.org\/wiki\/Low_back_pain \"Low back pain\")\n  - Liver: [hepatomegaly](https:\/\/en.wikipedia.org\/wiki\/Hepatomegaly \"Hepatomegaly\")\n  - Kidney: [kidney stone](https:\/\/en.wikipedia.org\/wiki\/Kidney_stone_disease \"Kidney stone disease\") (nephrolithiasis), complicated urinary tract infection\n- Left low back pain\n  - Spleen\n  - Kidney: [kidney stone](https:\/\/en.wikipedia.org\/wiki\/Kidney_stone_disease \"Kidney stone disease\") (nephrolithiasis), complicated urinary tract infection\n- Low back pain\n  - Kidney pain ([kidney stone](https:\/\/en.wikipedia.org\/wiki\/Kidney_stone \"Kidney stone\"), [kidney cancer](https:\/\/en.wikipedia.org\/wiki\/Kidney_cancer \"Kidney cancer\"), [hydronephrosis](https:\/\/en.wikipedia.org\/wiki\/Hydronephrosis \"Hydronephrosis\"))\n  - [Ureteral stone](https:\/\/en.wikipedia.org\/wiki\/Ureter#Ureteral_stones \"Ureter\") pain\n\n## Mechanism\n\\[[edit](https:\/\/en.wikipedia.org\/w\/index.php?title=Abdominal_pain&action=edit&section=13 \"Edit section: Mechanism\")\\]\n\n| Region | Blood supply[\\[14\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Moore_2016-14) | Innervation[\\[15\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-15) | Structures[\\[14\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Moore_2016-14) |\n|---|---|---|---|\n| [Foregut](https:\/\/en.wikipedia.org\/wiki\/Foregut \"Foregut\") | [Celiac artery](https:\/\/en.wikipedia.org\/wiki\/Celiac_artery \"Celiac artery\") | T5 - T9 | [Pharynx](https:\/\/en.wikipedia.org\/wiki\/Pharynx \"Pharynx\") [Esophagus](https:\/\/en.wikipedia.org\/wiki\/Esophagus \"Esophagus\")[Lower respiratory tract](https:\/\/en.wikipedia.org\/wiki\/Respiratory_tract \"Respiratory tract\")[Stomach](https:\/\/en.wikipedia.org\/wiki\/Stomach \"Stomach\")Proximal [duodenum](https:\/\/en.wikipedia.org\/wiki\/Duodenum \"Duodenum\")[Liver](https:\/\/en.wikipedia.org\/wiki\/Liver \"Liver\")[Biliary tract](https:\/\/en.wikipedia.org\/wiki\/Biliary_tract \"Biliary tract\")[Gallbladder](https:\/\/en.wikipedia.org\/wiki\/Gallbladder \"Gallbladder\")[Pancreas](https:\/\/en.wikipedia.org\/wiki\/Pancreas \"Pancreas\") |\n| [Midgut](https:\/\/en.wikipedia.org\/wiki\/Midgut \"Midgut\") | [Superior mesenteric artery](https:\/\/en.wikipedia.org\/wiki\/Superior_mesenteric_artery \"Superior mesenteric artery\") | T10 – T12 | Distal [duodenum](https:\/\/en.wikipedia.org\/wiki\/Duodenum \"Duodenum\") [Cecum](https:\/\/en.wikipedia.org\/wiki\/Cecum \"Cecum\")[Appendix](https:\/\/en.wikipedia.org\/wiki\/Appendix_\\(anatomy\\) \"Appendix (anatomy)\")[Ascending colon](https:\/\/en.wikipedia.org\/wiki\/Ascending_colon \"Ascending colon\")Proximal [transverse colon](https:\/\/en.wikipedia.org\/wiki\/Transverse_colon \"Transverse colon\") |\n| [Hindgut](https:\/\/en.wikipedia.org\/wiki\/Hindgut \"Hindgut\") | [Inferior mesenteric artery](https:\/\/en.wikipedia.org\/wiki\/Inferior_mesenteric_artery \"Inferior mesenteric artery\") | L1 – L3 | Distal [transverse colon](https:\/\/en.wikipedia.org\/wiki\/Transverse_colon \"Transverse colon\") [Descending colon](https:\/\/en.wikipedia.org\/wiki\/Descending_colon \"Descending colon\")[Sigmoid colon](https:\/\/en.wikipedia.org\/wiki\/Sigmoid_colon \"Sigmoid colon\")[Rectum](https:\/\/en.wikipedia.org\/wiki\/Rectum \"Rectum\")Superior [anal canal](https:\/\/en.wikipedia.org\/wiki\/Anal_canal \"Anal canal\") |\n\nAbdominal pain can be referred to as [visceral pain](https:\/\/en.wikipedia.org\/wiki\/Visceral_pain \"Visceral pain\") or [peritoneal](https:\/\/en.wikipedia.org\/wiki\/Peritoneum \"Peritoneum\") pain. The contents of the abdomen can be divided into the [foregut](https:\/\/en.wikipedia.org\/wiki\/Foregut \"Foregut\"), [midgut](https:\/\/en.wikipedia.org\/wiki\/Midgut \"Midgut\"), and [hindgut](https:\/\/en.wikipedia.org\/wiki\/Hindgut \"Hindgut\").[\\[14\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Moore_2016-14) The [foregut](https:\/\/en.wikipedia.org\/wiki\/Foregut \"Foregut\") contains the [pharynx](https:\/\/en.wikipedia.org\/wiki\/Pharynx \"Pharynx\"), lower [respiratory tract](https:\/\/en.wikipedia.org\/wiki\/Respiratory_tract \"Respiratory tract\"), portions of the [esophagus](https:\/\/en.wikipedia.org\/wiki\/Esophagus \"Esophagus\"), [stomach](https:\/\/en.wikipedia.org\/wiki\/Stomach \"Stomach\"), portions of the [duodenum](https:\/\/en.wikipedia.org\/wiki\/Duodenum \"Duodenum\") (proximal), [liver](https:\/\/en.wikipedia.org\/wiki\/Liver \"Liver\"), [biliary tract](https:\/\/en.wikipedia.org\/wiki\/Biliary_tract \"Biliary tract\") (including the [gallbladder](https:\/\/en.wikipedia.org\/wiki\/Gallbladder \"Gallbladder\") and [bile ducts](https:\/\/en.wikipedia.org\/wiki\/Bile_duct \"Bile duct\")), and the [pancreas](https:\/\/en.wikipedia.org\/wiki\/Pancreas \"Pancreas\").[\\[14\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Moore_2016-14) The midgut contains portions of the [duodenum](https:\/\/en.wikipedia.org\/wiki\/Duodenum \"Duodenum\") (distal), [cecum](https:\/\/en.wikipedia.org\/wiki\/Cecum \"Cecum\"), [appendix](https:\/\/en.wikipedia.org\/wiki\/Appendix_\\(anatomy\\) \"Appendix (anatomy)\"), [ascending colon](https:\/\/en.wikipedia.org\/wiki\/Ascending_colon \"Ascending colon\"), and first half of the [transverse colon](https:\/\/en.wikipedia.org\/wiki\/Transverse_colon \"Transverse colon\").[\\[14\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Moore_2016-14) The hindgut contains the distal half of the transverse colon, [descending colon](https:\/\/en.wikipedia.org\/wiki\/Descending_colon \"Descending colon\"), [sigmoid colon](https:\/\/en.wikipedia.org\/wiki\/Sigmoid_colon \"Sigmoid colon\"), [rectum](https:\/\/en.wikipedia.org\/wiki\/Rectum \"Rectum\"), and superior [anal canal](https:\/\/en.wikipedia.org\/wiki\/Anal_canal \"Anal canal\").[\\[14\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Moore_2016-14)\n\nEach subsection of the gut has an associated visceral afferent nerve that transmits sensory information from the viscera to the spinal cord.[\\[16\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-16) The visceral sensory information from the gut traveling to the spinal cord, termed the visceral afferent, is non-specific and overlaps with the somatic afferent nerves, which are very specific.[\\[17\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Neumayer_2013-17) Therefore, visceral afferent information traveling to the spinal cord can present in the distribution of the somatic afferent nerve; this is why [appendicitis](https:\/\/en.wikipedia.org\/wiki\/Appendicitis \"Appendicitis\") initially presents with T10 periumbilical pain when it first begins and becomes T12 pain as the abdominal wall peritoneum (which is rich with somatic afferent nerves) is involved.[\\[17\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Neumayer_2013-17)\n\n## Diagnosis\n\\[[edit](https:\/\/en.wikipedia.org\/w\/index.php?title=Abdominal_pain&action=edit&section=14 \"Edit section: Diagnosis\")\\]\n\nA thorough patient history and physical examination is used to better understand the underlying cause of abdominal pain.\n\nThe process of gathering a history may include:[\\[18\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Bickley_2016-18)\n\n- Identifying more information about the [chief complaint](https:\/\/en.wikipedia.org\/wiki\/Presenting_problem \"Presenting problem\") by eliciting a [history of present illness](https:\/\/en.wikipedia.org\/wiki\/History_of_the_present_illness \"History of the present illness\"); i.e. a narrative of the current symptoms such as the onset, location, duration, character, aggravating or relieving factors, and temporal nature of the pain. Identifying other possible factors may aid in the diagnosis of the underlying cause of abdominal pain, such as recent travel, recent contact with other ill individuals, and for females, a thorough [gynecologic](https:\/\/en.wikipedia.org\/wiki\/Gynaecology \"Gynaecology\") history.\n- Learning about the patient's past medical history, focusing on any prior issues or surgical procedures.\n- Clarifying the patient's current medication regimen, including prescriptions, over-the-counter medications, and supplements.\n- Confirming the patient's drug and food allergies.\n- Discussing with the patient any family history of disease processes, focusing on conditions that might resemble the patient's current presentation.\n- Discussing with the patient any health-related behaviors (e.g. tobacco use, alcohol consumption, drug use, and sexual activity) that might make certain diagnoses more likely.\n- Reviewing the presence of non-abdominal symptoms (e.g., [fever](https:\/\/en.wikipedia.org\/wiki\/Fever \"Fever\"), chills, [chest pain](https:\/\/en.wikipedia.org\/wiki\/Chest_pain \"Chest pain\"), [shortness of breath](https:\/\/en.wikipedia.org\/wiki\/Shortness_of_breath \"Shortness of breath\"), [vaginal bleeding](https:\/\/en.wikipedia.org\/wiki\/Vaginal_bleeding \"Vaginal bleeding\")) that can further clarify the diagnostic picture.\n- Using [Carnett's sign](https:\/\/en.wikipedia.org\/wiki\/Carnett%27s_sign \"Carnett's sign\") to differentiate between [visceral pain](https:\/\/en.wikipedia.org\/wiki\/Visceral_pain \"Visceral pain\") and pain originating in the muscles of the abdominal wall.[\\[19\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-19)\n\nAfter gathering a thorough history, one should perform a [physical exam](https:\/\/en.wikipedia.org\/wiki\/Physical_examination \"Physical examination\") in order to identify important physical signs that might clarify the diagnosis, including a [cardiovascular exam](https:\/\/en.wikipedia.org\/wiki\/Cardiovascular_examination \"Cardiovascular examination\"), lung exam, thorough abdominal exam, and for females, a [genitourinary](https:\/\/en.wikipedia.org\/wiki\/Genitourinary_system \"Genitourinary system\") exam.[\\[18\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Bickley_2016-18)\n\nAdditional investigations that can aid diagnosis include:[\\[20\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Cartwright_2008-20)\n\n- Blood tests including [complete blood count](https:\/\/en.wikipedia.org\/wiki\/Complete_blood_count \"Complete blood count\"), [basic metabolic panel](https:\/\/en.wikipedia.org\/wiki\/Basic_metabolic_panel \"Basic metabolic panel\"), [electrolytes](https:\/\/en.wikipedia.org\/wiki\/Electrolyte \"Electrolyte\"), [liver function tests](https:\/\/en.wikipedia.org\/wiki\/Liver_function_tests \"Liver function tests\"), [amylase](https:\/\/en.wikipedia.org\/wiki\/Amylase \"Amylase\"), [lipase](https:\/\/en.wikipedia.org\/wiki\/Lipase \"Lipase\"), [troponin I](https:\/\/en.wikipedia.org\/wiki\/Troponin_I \"Troponin I\"), and for females, a serum [pregnancy test](https:\/\/en.wikipedia.org\/wiki\/Pregnancy_test \"Pregnancy test\").\n- [Urinalysis](https:\/\/en.wikipedia.org\/wiki\/Urinalysis \"Urinalysis\")\n- Imaging including chest and abdominal [X-rays](https:\/\/en.wikipedia.org\/wiki\/X-ray \"X-ray\")\n- [Electrocardiogram](https:\/\/en.wikipedia.org\/wiki\/Electrocardiograph \"Electrocardiograph\")\n\nIf diagnosis remains unclear after history, examination, and basic investigations as above, then more advanced investigations may reveal a diagnosis. Such tests include:[\\[20\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Cartwright_2008-20)\n\n- [Computed tomography](https:\/\/en.wikipedia.org\/wiki\/Computed_tomography \"Computed tomography\") of the abdomen\/pelvis\n- Abdominal or pelvic [ultrasound](https:\/\/en.wikipedia.org\/wiki\/Ultrasound \"Ultrasound\")\n- [Endoscopy](https:\/\/en.wikipedia.org\/wiki\/Endoscopy \"Endoscopy\") or [colonoscopy](https:\/\/en.wikipedia.org\/wiki\/Colonoscopy \"Colonoscopy\")\n\n## Management\n\\[[edit](https:\/\/en.wikipedia.org\/w\/index.php?title=Abdominal_pain&action=edit&section=15 \"Edit section: Management\")\\]\n\nThe management of abdominal pain depends on many factors, including the etiology of the pain. Some behavioural changes implemented to prevent pain include: resting after a meal, chewing food completely and slowly, and avoiding stressful and high excitement situations after a meal. Such at home strategies may reduce the need to seek professional assistance via prevention of future abdominal pain.[\\[21\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-21) In the emergency department, a person presenting with abdominal pain may initially require IV fluids due to decreased intake secondary to abdominal pain and possible emesis or vomiting.[\\[22\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Mahadevan-22) Treatment for abdominal pain includes analgesia, such as non-opioid (ketorolac) and opioid medications ([morphine](https:\/\/en.wikipedia.org\/wiki\/Morphine \"Morphine\"), [fentanyl](https:\/\/en.wikipedia.org\/wiki\/Fentanyl \"Fentanyl\")).[\\[22\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Mahadevan-22) Choice of [analgesia](https:\/\/en.wikipedia.org\/wiki\/Analgesia \"Analgesia\") is dependent on the cause of the pain, as [ketorolac](https:\/\/en.wikipedia.org\/wiki\/Ketorolac \"Ketorolac\") can worsen some intra-abdominal processes.[\\[22\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Mahadevan-22) Patients presenting to the emergency department with abdominal pain may receive a \"GI cocktail\" that includes an [antacid](https:\/\/en.wikipedia.org\/wiki\/Antacid \"Antacid\") (examples include [omeprazole](https:\/\/en.wikipedia.org\/wiki\/Omeprazole \"Omeprazole\"), [famotidine](https:\/\/en.wikipedia.org\/wiki\/Famotidine \"Famotidine\"), [magnesium hydroxide](https:\/\/en.wikipedia.org\/wiki\/Magnesium_hydroxide \"Magnesium hydroxide\"), and [calcium carbonate](https:\/\/en.wikipedia.org\/wiki\/Calcium_carbonate \"Calcium carbonate\")) and [lidocaine](https:\/\/en.wikipedia.org\/wiki\/Lidocaine \"Lidocaine\").[\\[22\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Mahadevan-22) After addressing pain, there may be a role for [antimicrobial](https:\/\/en.wikipedia.org\/wiki\/Antimicrobial \"Antimicrobial\") treatment in some cases of abdominal pain.[\\[22\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Mahadevan-22) [Butylscopolamine](https:\/\/en.wikipedia.org\/wiki\/Butylscopolamine \"Butylscopolamine\") (Buscopan) is used to treat cramping abdominal pain with some success.[\\[23\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-23) Surgical management for causes of abdominal pain includes but is not limited to [cholecystectomy](https:\/\/en.wikipedia.org\/wiki\/Cholecystectomy \"Cholecystectomy\"), [appendectomy](https:\/\/en.wikipedia.org\/wiki\/Appendectomy \"Appendectomy\"), and exploratory [laparotomy](https:\/\/en.wikipedia.org\/wiki\/Laparotomy \"Laparotomy\").\\[*[citation needed](https:\/\/en.wikipedia.org\/wiki\/Wikipedia:Citation_needed \"Wikipedia:Citation needed\")*\\]\n\n### Emergencies\n\\[[edit](https:\/\/en.wikipedia.org\/w\/index.php?title=Abdominal_pain&action=edit&section=16 \"Edit section: Emergencies\")\\]\n\nBelow is a brief overview of abdominal pain emergencies.\n\n| Condition | Presentation | Diagnosis | Management |\n|---|---|---|---|\n| [Appendicitis](https:\/\/en.wikipedia.org\/wiki\/Appendicitis \"Appendicitis\")[\\[24\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Sherman_2016-24) | Abdominal pain, nausea, vomiting, fever Periumbilical pain, migrates to RLQ | Clinical (history and physical exam) Abdominal CT | Patient made NPO (nothing by mouth) IV fluids as neededGeneral surgery consultation, possible [appendectomy](https:\/\/en.wikipedia.org\/wiki\/Appendectomy \"Appendectomy\")AntibioticsPain control |\n| [Cholecystitis](https:\/\/en.wikipedia.org\/wiki\/Cholecystitis \"Cholecystitis\")[\\[24\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Sherman_2016-24) | Abdominal pain (RUQ, radiates epigastric), nausea, vomiting, fever, [Murphy's sign](https:\/\/en.wikipedia.org\/wiki\/Murphy%27s_sign \"Murphy's sign\") | Clinical (history and physical exam) Imaging (RUQ ultrasound)Labs ([leukocytosis](https:\/\/en.wikipedia.org\/wiki\/Leukocytosis \"Leukocytosis\"), [transamintis](https:\/\/en.wikipedia.org\/wiki\/Elevated_transaminases \"Elevated transaminases\"), [hyperbilirubinemia](https:\/\/en.wikipedia.org\/wiki\/Hyperbilirubinemia \"Hyperbilirubinemia\")) | Patient made NPO (nothing by mouth) IV fluids as neededGeneral surgery consultation, possible [cholecystectomy](https:\/\/en.wikipedia.org\/wiki\/Cholecystectomy \"Cholecystectomy\")AntibioticsPain, nausea control |\n| [Acute pancreatitis](https:\/\/en.wikipedia.org\/wiki\/Acute_pancreatitis \"Acute pancreatitis\")[\\[24\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Sherman_2016-24) | Abdominal pain (sharp epigastric, shooting to back), nausea, vomiting | Clinical (history and physical exam) Labs (elevated [lipase](https:\/\/en.wikipedia.org\/wiki\/Lipase \"Lipase\"))Imaging (abdominal CT, ultrasound) | Patient made NPO (nothing by mouth) IV fluids as neededPain, nausea controlPossibly consultation of [general surgery](https:\/\/en.wikipedia.org\/wiki\/Surgery \"Surgery\") or [interventional radiology](https:\/\/en.wikipedia.org\/wiki\/Interventional_radiology \"Interventional radiology\") |\n| [Bowel obstruction](https:\/\/en.wikipedia.org\/wiki\/Bowel_obstruction \"Bowel obstruction\")[\\[24\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Sherman_2016-24) | Abdominal pain (diffuse, crampy), [bilious](https:\/\/en.wikipedia.org\/wiki\/Bile \"Bile\") [emesis](https:\/\/en.wikipedia.org\/wiki\/Vomiting \"Vomiting\"), [constipation](https:\/\/en.wikipedia.org\/wiki\/Constipation \"Constipation\") | Clinical (history and physical exam) Imaging (abdominal X-ray, abdominal CT) | Patient made NPO (nothing by mouth) IV fluids as needed[Nasogastric tube](https:\/\/en.wikipedia.org\/wiki\/Nasogastric_intubation \"Nasogastric intubation\") placement[General surgery](https:\/\/en.wikipedia.org\/wiki\/General_surgery \"General surgery\") consultationPain control |\n| [Upper GI bleed](https:\/\/en.wikipedia.org\/wiki\/Upper_gastrointestinal_bleeding \"Upper gastrointestinal bleeding\")[\\[24\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Sherman_2016-24) | Abdominal pain (epigastric), [hematochezia](https:\/\/en.wikipedia.org\/wiki\/Hematochezia \"Hematochezia\"), [melena](https:\/\/en.wikipedia.org\/wiki\/Melena \"Melena\"), [hematemesis](https:\/\/en.wikipedia.org\/wiki\/Hematemesis \"Hematemesis\"), [hypovolemia](https:\/\/en.wikipedia.org\/wiki\/Hypovolemia \"Hypovolemia\") | Clinical (history & physical exam, including [digital rectal exam](https:\/\/en.wikipedia.org\/wiki\/Rectal_examination \"Rectal examination\")) Labs ([complete blood count](https:\/\/en.wikipedia.org\/wiki\/Complete_blood_count \"Complete blood count\"), coagulation profile, [transaminases](https:\/\/en.wikipedia.org\/wiki\/Transaminase \"Transaminase\"), [stool guaiac](https:\/\/en.wikipedia.org\/wiki\/Stool_guaiac_test \"Stool guaiac test\")) | Aggressive IV fluid resuscitation [Blood transfusion](https:\/\/en.wikipedia.org\/wiki\/Blood_transfusion \"Blood transfusion\") as neededMedications: [proton pump inhibitor](https:\/\/en.wikipedia.org\/wiki\/Proton-pump_inhibitor \"Proton-pump inhibitor\"), [octreotide](https:\/\/en.wikipedia.org\/wiki\/Octreotide \"Octreotide\")Stable patient: observationUnstable patient: consultation ([general surgery](https:\/\/en.wikipedia.org\/wiki\/General_surgery \"General surgery\"), [gastroenterology](https:\/\/en.wikipedia.org\/wiki\/Gastroenterology \"Gastroenterology\"), [interventional radiology](https:\/\/en.wikipedia.org\/wiki\/Interventional_radiology \"Interventional radiology\")) |\n| Lower [GI bleed](https:\/\/en.wikipedia.org\/wiki\/Gastrointestinal_bleeding \"Gastrointestinal bleeding\")[\\[24\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Sherman_2016-24) | Abdominal pain, [hematochezia](https:\/\/en.wikipedia.org\/wiki\/Hematochezia \"Hematochezia\"), [melena](https:\/\/en.wikipedia.org\/wiki\/Melena \"Melena\"), [hypovolemia](https:\/\/en.wikipedia.org\/wiki\/Hypovolemia \"Hypovolemia\") | Clinical (history and physical exam, including [digital rectal exam](https:\/\/en.wikipedia.org\/wiki\/Rectal_examination \"Rectal examination\")) Labs ([complete blood count](https:\/\/en.wikipedia.org\/wiki\/Complete_blood_count \"Complete blood count\"), coagulation profile, [transaminases](https:\/\/en.wikipedia.org\/wiki\/Transaminase \"Transaminase\"), [stool guaiac](https:\/\/en.wikipedia.org\/wiki\/Stool_guaiac_test \"Stool guaiac test\")) | Aggressive IV fluid resuscitation [Blood transfusion](https:\/\/en.wikipedia.org\/wiki\/Blood_transfusion \"Blood transfusion\") as neededMedications: [proton pump inhibitor](https:\/\/en.wikipedia.org\/wiki\/Proton-pump_inhibitor \"Proton-pump inhibitor\")Stable patient: observationUnstable patient: consultation ([general surgery](https:\/\/en.wikipedia.org\/wiki\/General_surgery \"General surgery\"), [gastroenterology](https:\/\/en.wikipedia.org\/wiki\/Gastroenterology \"Gastroenterology\"), [interventional radiology](https:\/\/en.wikipedia.org\/wiki\/Interventional_radiology \"Interventional radiology\")) |\n| Perforated Viscous[\\[24\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Sherman_2016-24) | Abdominal pain (sudden onset of localized pain), [abdominal distension](https:\/\/en.wikipedia.org\/wiki\/Abdominal_distension \"Abdominal distension\"), rigid abdomen | Clinical (history and physical exam) Imaging (abdominal X-ray or CT showing free air)Labs ([complete blood count](https:\/\/en.wikipedia.org\/wiki\/Complete_blood_count \"Complete blood count\")) | Aggressive IV fluid resuscitation [General surgery](https:\/\/en.wikipedia.org\/wiki\/General_surgery \"General surgery\") consultationAntibiotics |\n| [Volvulus](https:\/\/en.wikipedia.org\/wiki\/Volvulus \"Volvulus\")[\\[24\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Sherman_2016-24) | [Sigmoid colon volvulus](https:\/\/en.wikipedia.org\/wiki\/Sigmoid_colon_volvulus \"Sigmoid colon volvulus\"): Abdominal pain (\\>2 days, distention, constipation) Cecal volvulus: Abdominal pain (acute onset), nausea, vomiting | Clinical (history and physical exam) Imaging (abdominal X-ray or CT) | Sigmoid: [Gastroenterology](https:\/\/en.wikipedia.org\/wiki\/Gastroenterology \"Gastroenterology\") consultation ([flexibile sigmoidoscopy](https:\/\/en.wikipedia.org\/wiki\/Sigmoidoscopy \"Sigmoidoscopy\")) Cecal: [General surgery](https:\/\/en.wikipedia.org\/wiki\/General_surgery \"General surgery\") consultation ([right hemicolectomy](https:\/\/en.wikipedia.org\/wiki\/Colectomy \"Colectomy\")) |\n| [Ectopic pregnancy](https:\/\/en.wikipedia.org\/wiki\/Ectopic_pregnancy \"Ectopic pregnancy\")[\\[24\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Sherman_2016-24) | Abdominal and pelvic pain, bleeding If ruptured ectopic pregnancy, the patient may present with peritoneal irritation and [hypovolemic shock](https:\/\/en.wikipedia.org\/wiki\/Hypovolemic_shock \"Hypovolemic shock\") | Clinical (history and physical exam) Labs: [complete blood count](https:\/\/en.wikipedia.org\/wiki\/Complete_blood_count \"Complete blood count\"), urine pregnancy test followed with quantitative blood [beta-hCG](https:\/\/en.wikipedia.org\/wiki\/Human_chorionic_gonadotropin \"Human chorionic gonadotropin\")Imaging: [transvaginal ultrasound](https:\/\/en.wikipedia.org\/wiki\/Vaginal_ultrasonography \"Vaginal ultrasonography\") | If patient is unstable: IV fluid resuscitation, urgent [obstetrics and gynecology](https:\/\/en.wikipedia.org\/wiki\/Obstetrics_and_gynaecology \"Obstetrics and gynaecology\") consultation If patient is stable: continue diagnostic workup, establish [OBGYN](https:\/\/en.wikipedia.org\/wiki\/Obstetrics_and_gynaecology \"Obstetrics and gynaecology\") follow-up |\n| [Abdominal aortic aneurysm](https:\/\/en.wikipedia.org\/wiki\/Abdominal_aortic_aneurysm \"Abdominal aortic aneurysm\")[\\[24\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Sherman_2016-24) | Abdominal pain, flank pain, back pain, hypotension, pulsatile abdominal mass | Clinical (history and physical exam) Imaging: Ultrasound, [CT angiography](https:\/\/en.wikipedia.org\/wiki\/Computed_tomography_angiography \"Computed tomography angiography\"), MRA\/[magnetic resonance angiography](https:\/\/en.wikipedia.org\/wiki\/Magnetic_resonance_angiography \"Magnetic resonance angiography\") | If patient is unstable: IV fluid resuscitation, urgent surgical consultation If patient is stable: admit for observation |\n| [Aortic dissection](https:\/\/en.wikipedia.org\/wiki\/Aortic_dissection \"Aortic dissection\")[\\[24\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Sherman_2016-24) | Abdominal pain (sudden onset of epigastric or back pain), hypertension, new aortic [murmur](https:\/\/en.wikipedia.org\/wiki\/Heart_murmur \"Heart murmur\") | Clinical (history and physical exam) Imaging: Chest X-ray (showing widened [mediastinum](https:\/\/en.wikipedia.org\/wiki\/Mediastinum \"Mediastinum\")), [CT angiography](https:\/\/en.wikipedia.org\/wiki\/Computed_tomography_angiography \"Computed tomography angiography\"), [MRA](https:\/\/en.wikipedia.org\/wiki\/Magnetic_resonance_angiography \"Magnetic resonance angiography\"), [transthoracic echocardiogram](https:\/\/en.wikipedia.org\/wiki\/Transthoracic_echocardiogram \"Transthoracic echocardiogram\")\/TTE, [transesophageal echocardiogram](https:\/\/en.wikipedia.org\/wiki\/Transesophageal_echocardiogram \"Transesophageal echocardiogram\")\/TEE | IV fluid resuscitation [Blood transfusion](https:\/\/en.wikipedia.org\/wiki\/Blood_transfusion \"Blood transfusion\") as needed (obtain [type and cross](https:\/\/en.wikipedia.org\/wiki\/Blood_transfusion \"Blood transfusion\"))Medications: reduce blood pressure ([sodium nitroprusside](https:\/\/en.wikipedia.org\/wiki\/Sodium_nitroprusside \"Sodium nitroprusside\") plus [beta blocker](https:\/\/en.wikipedia.org\/wiki\/Beta_blocker \"Beta blocker\") or [calcium channel blocker](https:\/\/en.wikipedia.org\/wiki\/Calcium_channel_blocker \"Calcium channel blocker\"))Surgery consultation |\n| [Liver injury](https:\/\/en.wikipedia.org\/wiki\/Liver_injury \"Liver injury\")[\\[24\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Sherman_2016-24) | After trauma ([blunt](https:\/\/en.wikipedia.org\/wiki\/Blunt_trauma \"Blunt trauma\") or [penetrating](https:\/\/en.wikipedia.org\/wiki\/Penetrating_trauma \"Penetrating trauma\")), abdominal pain (RUQ), right rib pain, right flank pain, right shoulder pain | Clinical (history and physical exam) Imaging: [FAST](https:\/\/en.wikipedia.org\/wiki\/Focused_assessment_with_sonography_for_trauma \"Focused assessment with sonography for trauma\") examination, CT of abdomen and pelvis[Diagnostic peritoneal aspiration and lavage](https:\/\/en.wikipedia.org\/wiki\/Diagnostic_peritoneal_lavage \"Diagnostic peritoneal lavage\") | Resuscitation ([advanced trauma life support](https:\/\/en.wikipedia.org\/wiki\/Advanced_trauma_life_support \"Advanced trauma life support\")) with IV fluids ([crystalloid](https:\/\/en.wikipedia.org\/wiki\/Fluid_replacement \"Fluid replacement\")) and [blood transfusion](https:\/\/en.wikipedia.org\/wiki\/Blood_transfusion \"Blood transfusion\") If patient is unstable: [general](https:\/\/en.wikipedia.org\/wiki\/General_surgery \"General surgery\") or [trauma surgery](https:\/\/en.wikipedia.org\/wiki\/Trauma_surgery \"Trauma surgery\") consultation with subsequent [exploratory laparotomy](https:\/\/en.wikipedia.org\/wiki\/Exploratory_laparotomy \"Exploratory laparotomy\") |\n| [Splenic injury](https:\/\/en.wikipedia.org\/wiki\/Splenic_injury \"Splenic injury\")[\\[24\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Sherman_2016-24) | After trauma ([blunt](https:\/\/en.wikipedia.org\/wiki\/Blunt_trauma \"Blunt trauma\") or [penetrating](https:\/\/en.wikipedia.org\/wiki\/Penetrating_trauma \"Penetrating trauma\")), abdominal pain (LUQ), left rib pain, left flank pain | Clinical (history and physical exam) Imaging: [FAST](https:\/\/en.wikipedia.org\/wiki\/Focused_assessment_with_sonography_for_trauma \"Focused assessment with sonography for trauma\") examination, CT of abdomen and pelvis[Diagnostic peritoneal aspiration and lavage](https:\/\/en.wikipedia.org\/wiki\/Diagnostic_peritoneal_lavage \"Diagnostic peritoneal lavage\") | Resuscitation ([advanced trauma life support](https:\/\/en.wikipedia.org\/wiki\/Advanced_trauma_life_support \"Advanced trauma life support\")) with IV fluids ([crystalloid](https:\/\/en.wikipedia.org\/wiki\/Fluid_replacement \"Fluid replacement\")) and [blood transfusion](https:\/\/en.wikipedia.org\/wiki\/Blood_transfusion \"Blood transfusion\") If patient is unstable: [general](https:\/\/en.wikipedia.org\/wiki\/General_surgery \"General surgery\") or [trauma surgery](https:\/\/en.wikipedia.org\/wiki\/Trauma_surgery \"Trauma surgery\") consultation with subsequent [exploratory laparotomy](https:\/\/en.wikipedia.org\/wiki\/Exploratory_laparotomy \"Exploratory laparotomy\") and possible [splenectomy](https:\/\/en.wikipedia.org\/wiki\/Splenectomy \"Splenectomy\")If patient is stable: medical management, consultation of [interventional radiology](https:\/\/en.wikipedia.org\/wiki\/Interventional_radiology \"Interventional radiology\") for possible [arterial embolization](https:\/\/en.wikipedia.org\/wiki\/Embolization \"Embolization\") |\n\n## Outlook\n\\[[edit](https:\/\/en.wikipedia.org\/w\/index.php?title=Abdominal_pain&action=edit&section=17 \"Edit section: Outlook\")\\]\n\nOne well-known aspect of primary health care is its low prevalence of potentially dangerous abdominal pain causes. Patients with abdominal pain have a higher percentage of unexplained complaints (category \"no diagnosis\") than patients with other symptoms (such as [dyspnea](https:\/\/en.wikipedia.org\/wiki\/Dyspnea \"Dyspnea\") or [chest pain](https:\/\/en.wikipedia.org\/wiki\/Chest_pain \"Chest pain\")).[\\[25\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-A_C_T_R_p.-25) Most people who suffer from stomach pain have a benign issue, like [dyspepsia](https:\/\/en.wikipedia.org\/wiki\/Indigestion \"Indigestion\").[\\[26\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Gulacti_Arslan_Ooi_Tuck_2001_pp._123%E2%80%93136-26) In general, it is discovered that 20% to 25% of patients with abdominal pain have a serious condition that necessitates admission to an acute care hospital.[\\[27\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Chandramohan_Pari_Schrock_Lum_1991_pp._503%E2%80%93507-27)\n\n## Epidemiology\n\\[[edit](https:\/\/en.wikipedia.org\/w\/index.php?title=Abdominal_pain&action=edit&section=18 \"Edit section: Epidemiology\")\\]\n\nAbdominal pain is the reason about 3% of adults see their family physician.[\\[2\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Vin2014-2) Rates of [emergency department](https:\/\/en.wikipedia.org\/wiki\/Emergency_department \"Emergency department\") (ED) visits in the United States for abdominal pain increased 18% from 2006 through to 2011. This was the largest increase out of 20 common conditions seen in the ED. The rate of ED use for nausea and vomiting also increased 18%.[\\[28\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-28)\n\n## Special populations\n\\[[edit](https:\/\/en.wikipedia.org\/w\/index.php?title=Abdominal_pain&action=edit&section=19 \"Edit section: Special populations\")\\]\n\n### Geriatrics\n\\[[edit](https:\/\/en.wikipedia.org\/w\/index.php?title=Abdominal_pain&action=edit&section=20 \"Edit section: Geriatrics\")\\]\n\nMore time and resources are used on older patients with abdominal pain than on any other patient presentation in the emergency department (ED).[\\[29\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-SA_LZ_p.-29) Compared to younger patients with the same complaint, their length of stay is 20% longer, they need to be admitted almost half the time, and they need surgery 1\/3 of the time.[\\[30\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Rodr%C3%ADguez-Lomba_Pulido-P%C3%A9rez_Ricciardi_Marcello_1976_pp._219%E2%80%93223-30)\n\nAge does not reduce the total number of [T cells](https:\/\/en.wikipedia.org\/wiki\/T_cell \"T cell\"), but it does reduce their functionality. The elderly person's ability to fight infection is weakened as a result.[\\[31\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Weyand_Goronzy_p.-31) Additionally, they have changed the strength and integrity of their skin and [mucous membranes](https:\/\/en.wikipedia.org\/wiki\/Mucous_membrane \"Mucous membrane\"), which are physical barriers to infection. It is well known that older patients experience altered pain perception.[\\[32\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Sherman_p.-32)\n\nThe challenge of obtaining a sufficient history from an elderly patient can be attributed to multiple factors. Reduced memory or hearing could make the issue worse. It is common to encounter stoicism combined with a fear of losing one's independence if a serious condition is discovered. Changes in mental status, whether acute or chronic, are common.[\\[33\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Isani_Kim_Mateu_Tormo_2006_pp._371%E2%80%93388-33)\n\n### Pregnancy\n\\[[edit](https:\/\/en.wikipedia.org\/w\/index.php?title=Abdominal_pain&action=edit&section=21 \"Edit section: Pregnancy\")\\]\n\nUnique clinical challenges arise when pregnant women experience abdominal pain. First off, there are many possible causes of abdominal pain during pregnancy. These include intraabdominal diseases that arise incidentally during pregnancy as well as obstetric or gynecologic disorders associated with pregnancy. Secondly, pregnancy modifies the natural history and clinical manifestation of numerous abdominal disorders.[\\[34\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-34) Third, pregnancy modifies and limits the diagnostic assessment. For instance, concerns about fetal safety during pregnancy are raised by invasive exams and radiologic testing. Fourth, while receiving therapy during pregnancy, the mother's and the fetus' interests need to be taken into account.[\\[35\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Souza_Ferreira_Young_Cerit_2003_pp._1%E2%80%9358-35)\n\n## See also\n\\[[edit](https:\/\/en.wikipedia.org\/w\/index.php?title=Abdominal_pain&action=edit&section=22 \"Edit section: See also\")\\]\n\n- [Abdominal distension](https:\/\/en.wikipedia.org\/wiki\/Abdominal_distension \"Abdominal distension\")\n- [Abdominal mass](https:\/\/en.wikipedia.org\/wiki\/Abdominal_mass \"Abdominal mass\")\n\n## References\n\\[[edit](https:\/\/en.wikipedia.org\/w\/index.php?title=Abdominal_pain&action=edit&section=23 \"Edit section: References\")\\]\n\n1. **[^](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-Stat2018_1-0)**\n   Patterson JW, Dominique E (14 November 2018). \"Acute Abdomenal\". *StatPearls*. [PMID](https:\/\/en.wikipedia.org\/wiki\/PMID_\\(identifier\\) \"PMID (identifier)\") [29083722](https:\/\/pubmed.ncbi.nlm.nih.gov\/29083722).\n2. ^ [***a***](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-Vin2014_2-0) [***b***](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-Vin2014_2-1) [***c***](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-Vin2014_2-2) [***d***](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-Vin2014_2-3) [***e***](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-Vin2014_2-4)\n   Viniol A, Keunecke C, Biroga T, Stadje R, Dornieden K, Bösner S, et al. (October 2014). [\"Studies of the symptom abdominal pain—a systematic review and meta-analysis\"](https:\/\/doi.org\/10.1093%2Ffampra%2Fcmu036). *Family Practice*. **31** (5): 517–29\\. [doi](https:\/\/en.wikipedia.org\/wiki\/Doi_\\(identifier\\) \"Doi (identifier)\"):[10\\.1093\/fampra\/cmu036](https:\/\/doi.org\/10.1093%2Ffampra%2Fcmu036). [PMID](https:\/\/en.wikipedia.org\/wiki\/PMID_\\(identifier\\) \"PMID (identifier)\") [24987023](https:\/\/pubmed.ncbi.nlm.nih.gov\/24987023).\n3. ^ [***a***](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-Hopcroft2020_3-0) [***b***](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-Hopcroft2020_3-1)\n   Hopcroft K, Forte V (2020). [\"Abdomen\"](https:\/\/books.google.com\/books?id=pr_gDwAAQBAJ&pg=PA9). *Symptom Sorter* (6th ed.). Boca Raton: CRC Press. pp. 9–17\\. [ISBN](https:\/\/en.wikipedia.org\/wiki\/ISBN_\\(identifier\\) \"ISBN (identifier)\")\n   \n   [9780367468101](https:\/\/en.wikipedia.org\/wiki\/Special:BookSources\/9780367468101 \"Special:BookSources\/9780367468101\")\n   \n   .\n4. ^ [***a***](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-Sherman_1990_r770_4-0) [***b***](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-Sherman_1990_r770_4-1)\n   Sherman R (1990). [*Abdominal Pain*](https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK412\/). Butterworths. [ISBN](https:\/\/en.wikipedia.org\/wiki\/ISBN_\\(identifier\\) \"ISBN (identifier)\")\n   \n   [978-0-409-90077-4](https:\/\/en.wikipedia.org\/wiki\/Special:BookSources\/978-0-409-90077-4 \"Special:BookSources\/978-0-409-90077-4\")\n   \n   . [PMID](https:\/\/en.wikipedia.org\/wiki\/PMID_\\(identifier\\) \"PMID (identifier)\") [21250252](https:\/\/pubmed.ncbi.nlm.nih.gov\/21250252). Retrieved 28 December 2023.\n5. **[^](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-5)**\n   Hung A, Calderbank T, Samaan MA, Plumb AA, Webster G (1 January 2021). [\"Ischaemic colitis: practical challenges and evidence-based recommendations for management\"](https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC7802492). *Frontline Gastroenterology*. **12** (1): 44–52\\. [doi](https:\/\/en.wikipedia.org\/wiki\/Doi_\\(identifier\\) \"Doi (identifier)\"):[10\\.1136\/flgastro-2019-101204](https:\/\/doi.org\/10.1136%2Fflgastro-2019-101204). [ISSN](https:\/\/en.wikipedia.org\/wiki\/ISSN_\\(identifier\\) \"ISSN (identifier)\") [2041-4137](https:\/\/search.worldcat.org\/issn\/2041-4137). [PMC](https:\/\/en.wikipedia.org\/wiki\/PMC_\\(identifier\\) \"PMC (identifier)\") [7802492](https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC7802492). [PMID](https:\/\/en.wikipedia.org\/wiki\/PMID_\\(identifier\\) \"PMID (identifier)\") [33489068](https:\/\/pubmed.ncbi.nlm.nih.gov\/33489068).\n6. **[^](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-Spangler_2014_6-0)**\n   Spangler R, Van Pham T, Khoujah D, Martinez JP (2014). [\"Abdominal emergencies in the geriatric patient\"](https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4306086). *International Journal of Emergency Medicine*. **7** 43. [doi](https:\/\/en.wikipedia.org\/wiki\/Doi_\\(identifier\\) \"Doi (identifier)\"):[10\\.1186\/s12245-014-0043-2](https:\/\/doi.org\/10.1186%2Fs12245-014-0043-2). [PMC](https:\/\/en.wikipedia.org\/wiki\/PMC_\\(identifier\\) \"PMC (identifier)\") [4306086](https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4306086). [PMID](https:\/\/en.wikipedia.org\/wiki\/PMID_\\(identifier\\) \"PMID (identifier)\") [25635203](https:\/\/pubmed.ncbi.nlm.nih.gov\/25635203).\n7. ^ [***a***](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-aa_7-0) [***b***](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-aa_7-1) [***c***](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-aa_7-2) [***d***](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-aa_7-3) [***e***](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-aa_7-4)\n   Patterson JW, Kashyap S, Dominique E (2023), [\"Acute Abdomen\"](https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK459328\/), *StatPearls*, Treasure Island (FL): StatPearls Publishing, [PMID](https:\/\/en.wikipedia.org\/wiki\/PMID_\\(identifier\\) \"PMID (identifier)\") [29083722](https:\/\/pubmed.ncbi.nlm.nih.gov\/29083722), retrieved 23 September 2023\n8. **[^](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-8)**\n   [\"Appendicitis\"](https:\/\/www.lecturio.com\/concepts\/appendicitis\/). *The Lecturio Medical Concept Library*. Retrieved 1 July 2021.\n9. **[^](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-9)**\n   Arendt-Nielsen L, Svensson P (March 2001). [\"Referred Muscle Pain: Basic and Clinical Findings\"](https:\/\/doi.org\/10.1097%2F00002508-200103000-00003). *The Clinical Journal of Pain*. **17** (1): 11–19\\. [doi](https:\/\/en.wikipedia.org\/wiki\/Doi_\\(identifier\\) \"Doi (identifier)\"):[10\\.1097\/00002508-200103000-00003](https:\/\/doi.org\/10.1097%2F00002508-200103000-00003). [ISSN](https:\/\/en.wikipedia.org\/wiki\/ISSN_\\(identifier\\) \"ISSN (identifier)\") [0749-8047](https:\/\/search.worldcat.org\/issn\/0749-8047). [PMID](https:\/\/en.wikipedia.org\/wiki\/PMID_\\(identifier\\) \"PMID (identifier)\") [11289083](https:\/\/pubmed.ncbi.nlm.nih.gov\/11289083).\n10. **[^](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-10)**\n    Collantes Celador E, Rudiger J, Tameem A, eds. (2022). *Essential Notes in Pain Medicine* (1st ed.). United Kingdom: Oxford University Press. [doi](https:\/\/en.wikipedia.org\/wiki\/Doi_\\(identifier\\) \"Doi (identifier)\"):[10\\.1093\/med\/9780198799443.001.0001](https:\/\/doi.org\/10.1093%2Fmed%2F9780198799443.001.0001). [ISBN](https:\/\/en.wikipedia.org\/wiki\/ISBN_\\(identifier\\) \"ISBN (identifier)\")\n    \n    [978-0-19-879944-3](https:\/\/en.wikipedia.org\/wiki\/Special:BookSources\/978-0-19-879944-3 \"Special:BookSources\/978-0-19-879944-3\")\n    \n    .\n11. **[^](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-11)**\n    Burnett LS (April 1988). \"Gynecologic causes of the acute abdomen\". *The Surgical Clinics of North America*. **68** (2): 385–398\\. [doi](https:\/\/en.wikipedia.org\/wiki\/Doi_\\(identifier\\) \"Doi (identifier)\"):[10\\.1016\/s0039-6109(16)44484-1](https:\/\/doi.org\/10.1016%2Fs0039-6109%2816%2944484-1). [ISSN](https:\/\/en.wikipedia.org\/wiki\/ISSN_\\(identifier\\) \"ISSN (identifier)\") [0039-6109](https:\/\/search.worldcat.org\/issn\/0039-6109). [PMID](https:\/\/en.wikipedia.org\/wiki\/PMID_\\(identifier\\) \"PMID (identifier)\") [3279553](https:\/\/pubmed.ncbi.nlm.nih.gov\/3279553).\n12. **[^](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-12)**\n    Masters P (2015). *IM Essentials*. American College of Physicians. [ISBN](https:\/\/en.wikipedia.org\/wiki\/ISBN_\\(identifier\\) \"ISBN (identifier)\")\n    \n    [978-1-938921-09-4](https:\/\/en.wikipedia.org\/wiki\/Special:BookSources\/978-1-938921-09-4 \"Special:BookSources\/978-1-938921-09-4\")\n    \n    .\n13. **[^](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-13)**\n    LeBlond RF (2004). *Diagnostics*. US: McGraw-Hill Companies, Inc. [ISBN](https:\/\/en.wikipedia.org\/wiki\/ISBN_\\(identifier\\) \"ISBN (identifier)\")\n    \n    [978-0-07-140923-0](https:\/\/en.wikipedia.org\/wiki\/Special:BookSources\/978-0-07-140923-0 \"Special:BookSources\/978-0-07-140923-0\")\n    \n    .\n14. ^ [***a***](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-Moore_2016_14-0) [***b***](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-Moore_2016_14-1) [***c***](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-Moore_2016_14-2) [***d***](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-Moore_2016_14-3) [***e***](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-Moore_2016_14-4) [***f***](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-Moore_2016_14-5)\n    Moore KL (2016). \"11\". *The Developing Human Tenth Edition*. Philadelphia, PA: Elsevier, Inc. pp. 209–240\\. [ISBN](https:\/\/en.wikipedia.org\/wiki\/ISBN_\\(identifier\\) \"ISBN (identifier)\")\n    \n    [978-0-323-31338-4](https:\/\/en.wikipedia.org\/wiki\/Special:BookSources\/978-0-323-31338-4 \"Special:BookSources\/978-0-323-31338-4\")\n    \n    .\n15. **[^](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-15)**\n    Hansen JT (2019). \"4: Abdomen\". *Netter's Clinical Anatomy, 4e*. Philadelphia, PA: Elsevier. pp. 157–231\\. [ISBN](https:\/\/en.wikipedia.org\/wiki\/ISBN_\\(identifier\\) \"ISBN (identifier)\")\n    \n    [978-0-323-53188-7](https:\/\/en.wikipedia.org\/wiki\/Special:BookSources\/978-0-323-53188-7 \"Special:BookSources\/978-0-323-53188-7\")\n    \n    .\n16. **[^](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-16)**\n    Drake RL, Vogl AW, Mitchell AW (2015). \"4: Abdomen\". *Gray's Anatomy For Students* (Third ed.). Churchill Livingstone Elsevier. pp. 253–420\\. [ISBN](https:\/\/en.wikipedia.org\/wiki\/ISBN_\\(identifier\\) \"ISBN (identifier)\")\n    \n    [978-0-7020-5131-9](https:\/\/en.wikipedia.org\/wiki\/Special:BookSources\/978-0-7020-5131-9 \"Special:BookSources\/978-0-7020-5131-9\")\n    \n    .\n17. ^ [***a***](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-Neumayer_2013_17-0) [***b***](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-Neumayer_2013_17-1)\n    Neumayer L, Dangleben DA, Fraser S, Gefen J, Maa J, Mann BD (2013). \"11: Abdominal Wall, Including Hernia\". *Essentials of General Surgery, 5e*. Baltimore, MD: Wolters Kluwer Health.\n18. ^ [***a***](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-Bickley_2016_18-0) [***b***](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-Bickley_2016_18-1)\n    Bickley L (2016). *Bates' Guide to Physical Examination & History Taking*. Philadelphia, Pennsylvania: Lippincott Williams & Wilkins. [ISBN](https:\/\/en.wikipedia.org\/wiki\/ISBN_\\(identifier\\) \"ISBN (identifier)\")\n    \n    [978-1-4698-9341-9](https:\/\/en.wikipedia.org\/wiki\/Special:BookSources\/978-1-4698-9341-9 \"Special:BookSources\/978-1-4698-9341-9\")\n    \n    .\n19. **[^](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-19)**\n    Karen M. Myrick, Laima Karosas (6 December 2019). [*Advanced Health Assessment and Differential Diagnosis: Essentials for Clinical Practice*](https:\/\/books.google.com\/books?id=QTCeDwAAQBAJ&q=%22Carnett's+sign%22+diagnosis). Springer Publishing Company. p. 250. [ISBN](https:\/\/en.wikipedia.org\/wiki\/ISBN_\\(identifier\\) \"ISBN (identifier)\")\n    \n    [978-0-8261-6255-7](https:\/\/en.wikipedia.org\/wiki\/Special:BookSources\/978-0-8261-6255-7 \"Special:BookSources\/978-0-8261-6255-7\")\n    \n    .\n20. ^ [***a***](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-Cartwright_2008_20-0) [***b***](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-Cartwright_2008_20-1)\n    Cartwright SL, Knudson MP (April 2008). [\"Evaluation of acute abdominal pain in adults\"](http:\/\/www.aafp.org\/afp\/2008\/0401\/p971.html). *American Family Physician*. **77** (7): 971–8\\. [PMID](https:\/\/en.wikipedia.org\/wiki\/PMID_\\(identifier\\) \"PMID (identifier)\") [18441863](https:\/\/pubmed.ncbi.nlm.nih.gov\/18441863).\n21. **[^](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-21)**\n    [\"Indigestion: MedlinePlus Medical Encyclopedia\"](https:\/\/medlineplus.gov\/ency\/article\/003260.htm). *medlineplus.gov*. Retrieved 2 May 2023.\n22. ^ [***a***](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-Mahadevan_22-0) [***b***](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-Mahadevan_22-1) [***c***](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-Mahadevan_22-2) [***d***](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-Mahadevan_22-3) [***e***](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-Mahadevan_22-4)\n    Mahadevan SV. *Essentials of Family Medicine 6e*. p. 149.\n23. **[^](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-23)**\n    Tytgat GN (2007). \"Hyoscine butylbromide: a review of its use in the treatment of abdominal cramping and pain\". *Drugs*. **67** (9): 1343–57\\. [doi](https:\/\/en.wikipedia.org\/wiki\/Doi_\\(identifier\\) \"Doi (identifier)\"):[10\\.2165\/00003495-200767090-00007](https:\/\/doi.org\/10.2165%2F00003495-200767090-00007). [PMID](https:\/\/en.wikipedia.org\/wiki\/PMID_\\(identifier\\) \"PMID (identifier)\") [17547475](https:\/\/pubmed.ncbi.nlm.nih.gov\/17547475). [S2CID](https:\/\/en.wikipedia.org\/wiki\/S2CID_\\(identifier\\) \"S2CID (identifier)\") [46971321](https:\/\/api.semanticscholar.org\/CorpusID:46971321).\n24. ^ [***a***](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-Sherman_2016_24-0) [***b***](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-Sherman_2016_24-1) [***c***](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-Sherman_2016_24-2) [***d***](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-Sherman_2016_24-3) [***e***](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-Sherman_2016_24-4) [***f***](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-Sherman_2016_24-5) [***g***](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-Sherman_2016_24-6) [***h***](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-Sherman_2016_24-7) [***i***](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-Sherman_2016_24-8) [***j***](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-Sherman_2016_24-9) [***k***](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-Sherman_2016_24-10) [***l***](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-Sherman_2016_24-11) [***m***](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-Sherman_2016_24-12)\n    Sherman SC, Cico SJ, Nordquist E, Ross C, Wang E (2016). *Atlas of Clinical Emergency Medicine*. Wolters Kluwer. [ISBN](https:\/\/en.wikipedia.org\/wiki\/ISBN_\\(identifier\\) \"ISBN (identifier)\")\n    \n    [978-1-4511-8882-0](https:\/\/en.wikipedia.org\/wiki\/Special:BookSources\/978-1-4511-8882-0 \"Special:BookSources\/978-1-4511-8882-0\")\n    \n    .\n25. **[^](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-A_C_T_R_p._25-0)**\n    Viniol A, Keunecke C, Biroga T, Stadje R, Dornieden K, Bösner S, et al. (2014). \"Studies of the symptom abdominal pain—a systematic review and meta-analysis\". *Family Practice*. **31** (5): 517–529\\. [doi](https:\/\/en.wikipedia.org\/wiki\/Doi_\\(identifier\\) \"Doi (identifier)\"):[10\\.1093\/fampra\/cmu036](https:\/\/doi.org\/10.1093%2Ffampra%2Fcmu036). [ISSN](https:\/\/en.wikipedia.org\/wiki\/ISSN_\\(identifier\\) \"ISSN (identifier)\") [1460-2229](https:\/\/search.worldcat.org\/issn\/1460-2229). [PMID](https:\/\/en.wikipedia.org\/wiki\/PMID_\\(identifier\\) \"PMID (identifier)\") [24987023](https:\/\/pubmed.ncbi.nlm.nih.gov\/24987023).\n26. **[^](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-Gulacti_Arslan_Ooi_Tuck_2001_pp._123%E2%80%93136_26-0)**\n    Gulacti U, Arslan E, Ooi MW, Tuck J, Mattu A, Dubosh NM, et al. (1 February 2001). \"Abdominal Pain and Emergency Department Evaluation\". *Emergency Medicine Clinics of North America*. **19** (1). Elsevier: 123–136\\. [doi](https:\/\/en.wikipedia.org\/wiki\/Doi_\\(identifier\\) \"Doi (identifier)\"):[10\\.1016\/S0733-8627(05)70171-1](https:\/\/doi.org\/10.1016%2FS0733-8627%2805%2970171-1). [ISSN](https:\/\/en.wikipedia.org\/wiki\/ISSN_\\(identifier\\) \"ISSN (identifier)\") [0733-8627](https:\/\/search.worldcat.org\/issn\/0733-8627). [PMID](https:\/\/en.wikipedia.org\/wiki\/PMID_\\(identifier\\) \"PMID (identifier)\") [11214394](https:\/\/pubmed.ncbi.nlm.nih.gov\/11214394).\n27. **[^](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-Chandramohan_Pari_Schrock_Lum_1991_pp._503%E2%80%93507_27-0)**\n    Chandramohan R, Pari L, Schrock JW, Lum M, Örnek N, Usta G, et al. (1 May 1991). \"Probability of appendicitis before and after observation\". *Annals of Emergency Medicine*. **20** (5). Mosby: 503–507\\. [doi](https:\/\/en.wikipedia.org\/wiki\/Doi_\\(identifier\\) \"Doi (identifier)\"):[10\\.1016\/S0196-0644(05)81603-8](https:\/\/doi.org\/10.1016%2FS0196-0644%2805%2981603-8). [ISSN](https:\/\/en.wikipedia.org\/wiki\/ISSN_\\(identifier\\) \"ISSN (identifier)\") [0196-0644](https:\/\/search.worldcat.org\/issn\/0196-0644). [PMID](https:\/\/en.wikipedia.org\/wiki\/PMID_\\(identifier\\) \"PMID (identifier)\") [2024789](https:\/\/pubmed.ncbi.nlm.nih.gov\/2024789).\n28. **[^](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-28)**\n    Skiner HG, Blanchard J, Elixhauser A (September 2014). [\"Trends in Emergency Department Visits, 2006–2011\"](https:\/\/www.hcup-us.ahrq.gov\/reports\/statbriefs\/sb179-Emergency-Department-Trends.jsp). *HCUP Statistical Brief* (179). Rockville, MD: Agency for Healthcare Research and Quality.\n29. **[^](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-SA_LZ_p._29-0)**\n    Baum SA, Rubenstein LZ (1987). \"Old people in the emergency room: age-related differences in emergency department use and care\". *Journal of the American Geriatrics Society*. **35** (5): 398–404\\. [doi](https:\/\/en.wikipedia.org\/wiki\/Doi_\\(identifier\\) \"Doi (identifier)\"):[10\\.1111\/j.1532-5415.1987.tb04660.x](https:\/\/doi.org\/10.1111%2Fj.1532-5415.1987.tb04660.x). [ISSN](https:\/\/en.wikipedia.org\/wiki\/ISSN_\\(identifier\\) \"ISSN (identifier)\") [0002-8614](https:\/\/search.worldcat.org\/issn\/0002-8614). [PMID](https:\/\/en.wikipedia.org\/wiki\/PMID_\\(identifier\\) \"PMID (identifier)\") [3571788](https:\/\/pubmed.ncbi.nlm.nih.gov\/3571788). [S2CID](https:\/\/en.wikipedia.org\/wiki\/S2CID_\\(identifier\\) \"S2CID (identifier)\") [30731138](https:\/\/api.semanticscholar.org\/CorpusID:30731138).\n30. **[^](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-Rodr%C3%ADguez-Lomba_Pulido-P%C3%A9rez_Ricciardi_Marcello_1976_pp._219%E2%80%93223_30-0)**\n    Rodríguez-Lomba E, Pulido-Pérez A, Ricciardi R, Marcello PW, Kuki I, Nakane S, et al. (1 February 1976). \"Abdominal pain: An analysis of 1,000 consecutive cases in a university hospital emergency room\". *The American Journal of Surgery*. **131** (2). Elsevier: 219–223\\. [doi](https:\/\/en.wikipedia.org\/wiki\/Doi_\\(identifier\\) \"Doi (identifier)\"):[10\\.1016\/0002-9610(76)90101-X](https:\/\/doi.org\/10.1016%2F0002-9610%2876%2990101-X). [ISSN](https:\/\/en.wikipedia.org\/wiki\/ISSN_\\(identifier\\) \"ISSN (identifier)\") [0002-9610](https:\/\/search.worldcat.org\/issn\/0002-9610). [PMID](https:\/\/en.wikipedia.org\/wiki\/PMID_\\(identifier\\) \"PMID (identifier)\") [1251963](https:\/\/pubmed.ncbi.nlm.nih.gov\/1251963).\n31. **[^](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-Weyand_Goronzy_p._31-0)**\n    Weyand CM, Goronzy rJ (2016). [\"Aging of the Immune System. Mechanisms and Therapeutic Targets\"](https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5291468). *Annals of the American Thoracic Society*. **13** (Suppl 5). American Thoracic Society: S422–S428. [doi](https:\/\/en.wikipedia.org\/wiki\/Doi_\\(identifier\\) \"Doi (identifier)\"):[10\\.1513\/AnnalsATS.201602-095AW](https:\/\/doi.org\/10.1513%2FAnnalsATS.201602-095AW). [PMC](https:\/\/en.wikipedia.org\/wiki\/PMC_\\(identifier\\) \"PMC (identifier)\") [5291468](https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5291468). [PMID](https:\/\/en.wikipedia.org\/wiki\/PMID_\\(identifier\\) \"PMID (identifier)\") [28005419](https:\/\/pubmed.ncbi.nlm.nih.gov\/28005419).\n32. **[^](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-Sherman_p._32-0)**\n    Sherman ED, Robillard E (1964). \"Sensitivity to Pain in Relationship to Age\". *Journal of the American Geriatrics Society*. **12** (11): 1037–1044\\. [doi](https:\/\/en.wikipedia.org\/wiki\/Doi_\\(identifier\\) \"Doi (identifier)\"):[10\\.1111\/j.1532-5415.1964.tb00652.x](https:\/\/doi.org\/10.1111%2Fj.1532-5415.1964.tb00652.x). [ISSN](https:\/\/en.wikipedia.org\/wiki\/ISSN_\\(identifier\\) \"ISSN (identifier)\") [0002-8614](https:\/\/search.worldcat.org\/issn\/0002-8614). [PMID](https:\/\/en.wikipedia.org\/wiki\/PMID_\\(identifier\\) \"PMID (identifier)\") [14217863](https:\/\/pubmed.ncbi.nlm.nih.gov\/14217863). [S2CID](https:\/\/en.wikipedia.org\/wiki\/S2CID_\\(identifier\\) \"S2CID (identifier)\") [26336124](https:\/\/api.semanticscholar.org\/CorpusID:26336124).\n33. **[^](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-Isani_Kim_Mateu_Tormo_2006_pp._371%E2%80%93388_33-0)**\n    Isani MA, Kim ES, Mateu PB, Tormo FB, Thilakarathna K, Xie G, et al. (1 May 2006). \"Abdominal Pain in the Elderly\". *Emergency Medicine Clinics of North America*. **24** (2). Elsevier: 371–388\\. [doi](https:\/\/en.wikipedia.org\/wiki\/Doi_\\(identifier\\) \"Doi (identifier)\"):[10\\.1016\/j.emc.2006.01.010](https:\/\/doi.org\/10.1016%2Fj.emc.2006.01.010). [ISSN](https:\/\/en.wikipedia.org\/wiki\/ISSN_\\(identifier\\) \"ISSN (identifier)\") [0733-8627](https:\/\/search.worldcat.org\/issn\/0733-8627). [PMID](https:\/\/en.wikipedia.org\/wiki\/PMID_\\(identifier\\) \"PMID (identifier)\") [16584962](https:\/\/pubmed.ncbi.nlm.nih.gov\/16584962).\n34. **[^](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-34)**\n    Odubamowo K, Chilaka C, Walker K (2022). [\"Abdominal pain in late pregnancy (‡24 weeks' gestation)\"](https:\/\/pdf.sciencedirectassets.com\/273615\/1-s2.0-S1751721422X00079\/1-s2.0-S1751721422000896\/main.pdf?X-Amz-Security-Token=IQoJb3JpZ2luX2VjEL%2F%2F%2F%2F%2F%2F%2F%2F%2F%2F%2FwEaCXVzLWVhc3QtMSJGMEQCIEfiqG1MrLs9dhugOfvdLbbzZ8CQzGMq2hHxNR5K689zAiAwmauFQBhwIK5hrtFv2f2TVu8zJvXG5Ud%2F6D%2BLR%2BthnSq7BQi4%2F%2F%2F%2F%2F%2F%2F%2F%2F%2F8BEAUaDDA1OTAwMzU0Njg2NSIM%2Ff%2BcEuyXVsMFuyP%2BKo8FxHw7YHdLP0CAhNNQV1kQgZ8cRfl%2BPdDPdIt2gn%2Fyrn6rAbOrIOVnWOArsf%2BCI8hJyeO%2FXewl6fAWsnfann5aQVTG8Cq%2BNywCj%2FmA5q9WtZoPfUjIPqRNVvQwug%2B%2FaNjE3T81Nzc4YKTGtIbK7ZDsM0cHk4Y13aK8oBZApvgWEKVqDuUOlLyOhLqof0CXI3Jdo1ByC8wSQM6NrJSx1jxkGJ1ln00kKV1CnIn3loMr44Elelhoc3oAzSuh9XjTZtlR%2BFUf5YZLFGBlFW4%2FBQyOnIGoSKoq0RLybw1MtV6JNII8zHhATlyTvfW6T0VfZlSL3IyXwQezMYIf1V0ILDrh%2FeG5wtMxkHhvFmtSgI7rYq4D0TaOP75pWG2Ej%2BfLW7Hx1w8H62vAmfZRYYBpWEm610umvABT4WvC584xnpyfXZAIktZX7Suxfkn1504XfntL6AjIEk3vau%2FYnPUHyyGNYyyb53l9c234nqECwtKq7zoi2yz3dnZ2nXH%2FxIXwnA5dNGgpxoC%2Bz1B9nDmK%2Bm6%2FG3YiTubgAfudLEtLBJM8Nxwtz6GyuIxEx2k1VOuk6xeuVfPHE6yTgEkw93okOrOBQU2BnW109pgjJRmmUqoEV1rQdSCAbHfrGiNxl%2BHOh8lzYdxXw7BdV7QoO5i3FgfVJbLg%2FwwC%2FTw79vwSbGkIin7NlHXrEF8UzA0b8fDICxRDtyqPvrnB%2FHuWFh7%2F%2BLRguPw%2FLMHnak3geEeMScBnMNfRZv4hWkSUsDMShHh6DobOW0uHXiOQMmIYY4jar%2Blb%2FfCL%2FizTPXbd%2FxsUmfrxuLlpChm54jE8EDBOXpAiIOU14EOxU5csVmVEkWVZX6MTK6l%2BNOz2pVt2DU7pcNLZZTDl%2B7y8BjqyAdZMwi0NbY5KdWmnMqW0nwqT6YQy%2BZVh6tWGgHdJHS9ZOEcw3nxY8mAW5yX67t%2FQiaosCSJMgOdBjXYXUeV0VeVTCq9OdU26dayIbv2a7t9mLRJJu1CqwT4YoaTxxD6vMTv0fRhtqe4czvBlrCMY31hAOHBHlLyw%2FPfWmPJYhfNRmboQD4Dkhp%2Bgxie0gOBJJwnVqe1mcIgHcnPfuVe%2FFdxBoS3jCe0O%2FH%2BI0nWF4kIlYFg%3D&X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Date=20250121T073410Z&X-Amz-SignedHeaders=host&X-Amz-Expires=300&X-Amz-Credential=ASIAQ3PHCVTYTGJZ23NM%2F20250121%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Signature=8b5eb70d56adaffdd035dc032c7cbd2c8bffcbe7c29666223a4787a2e3401f72&hash=7d590af2be0262f89488f07391ebf21f92956ceab55bffc1c8057a2f03555a8c&host=68042c943591013ac2b2430a89b270f6af2c76d8dfd086a07176afe7c76c2c61&pii=S1751721422000896&tid=spdf-ebbe3e12-1389-4ef8-9b2d-05a0726c0f84&sid=1bd83b041bcdc1463d4842e10910150a607agxrqa&type=client&tsoh=d3d3LnNjaWVuY2VkaXJlY3QuY29t&ua=1b135e5050555d0a065708&rr=90559ec6f8a687c4&cc=au) (PDF). *Obstetrics, Gynaecology and Reproductive Medicine*. **32** (7): 141–151\\. [doi](https:\/\/en.wikipedia.org\/wiki\/Doi_\\(identifier\\) \"Doi (identifier)\"):[10\\.1016\/j.ogrm.2022.04.008](https:\/\/doi.org\/10.1016%2Fj.ogrm.2022.04.008).\n35. **[^](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-Souza_Ferreira_Young_Cerit_2003_pp._1%E2%80%9358_35-0)**\n    Souza Fd, Ferreira CH, Young RC, Cerit L, Lejong M, Louryan S, et al. (1 March 2003). \"Abdominal pain during pregnancy\". *Gastroenterology Clinics of North America*. **32** (1). Elsevier: 1–58\\. [doi](https:\/\/en.wikipedia.org\/wiki\/Doi_\\(identifier\\) \"Doi (identifier)\"):[10\\.1016\/S0889-8553(02)00064-X](https:\/\/doi.org\/10.1016%2FS0889-8553%2802%2900064-X). [ISSN](https:\/\/en.wikipedia.org\/wiki\/ISSN_\\(identifier\\) \"ISSN (identifier)\") [0889-8553](https:\/\/search.worldcat.org\/issn\/0889-8553). [PMID](https:\/\/en.wikipedia.org\/wiki\/PMID_\\(identifier\\) \"PMID (identifier)\") [12635413](https:\/\/pubmed.ncbi.nlm.nih.gov\/12635413).\n\n## Further reading\n\\[[edit](https:\/\/en.wikipedia.org\/w\/index.php?title=Abdominal_pain&action=edit&section=24 \"Edit section: Further reading\")\\]\n\n- Shinar Z, Dembitsky W, Smith ME, Moak JH, Traub SJ, Saghafian S, et al. (1 September 2011). \"Abdominal pain in the ED: a 35 year retrospective\". *The American Journal of Emergency Medicine*. **29** (7). W.B. Saunders: 711–716\\. [doi](https:\/\/en.wikipedia.org\/wiki\/Doi_\\(identifier\\) \"Doi (identifier)\"):[10\\.1016\/j.ajem.2010.01.045](https:\/\/doi.org\/10.1016%2Fj.ajem.2010.01.045). [ISSN](https:\/\/en.wikipedia.org\/wiki\/ISSN_\\(identifier\\) \"ISSN (identifier)\") [0735-6757](https:\/\/search.worldcat.org\/issn\/0735-6757). [PMID](https:\/\/en.wikipedia.org\/wiki\/PMID_\\(identifier\\) \"PMID (identifier)\") [20825873](https:\/\/pubmed.ncbi.nlm.nih.gov\/20825873).\n- Farmer AD, Aziz Q (2014). [\"Mechanisms and management of functional abdominal pain\"](https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4206626). *Journal of the Royal Society of Medicine*. **107** (9): 347–354\\. [doi](https:\/\/en.wikipedia.org\/wiki\/Doi_\\(identifier\\) \"Doi (identifier)\"):[10\\.1177\/0141076814540880](https:\/\/doi.org\/10.1177%2F0141076814540880). [ISSN](https:\/\/en.wikipedia.org\/wiki\/ISSN_\\(identifier\\) \"ISSN (identifier)\") [0141-0768](https:\/\/search.worldcat.org\/issn\/0141-0768). [PMC](https:\/\/en.wikipedia.org\/wiki\/PMC_\\(identifier\\) \"PMC (identifier)\") [4206626](https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4206626). [PMID](https:\/\/en.wikipedia.org\/wiki\/PMID_\\(identifier\\) \"PMID (identifier)\") [25193056](https:\/\/pubmed.ncbi.nlm.nih.gov\/25193056).\n- Akasaka E, Sawamura D, Rokunohe D, Sawamura D, Talukdar R, Reddy DN, et al. (1 February 2006). \"Abdominal Pain in Children\". *Pediatric Clinics of North America*. **53** (1). Elsevier: 107–137\\. [doi](https:\/\/en.wikipedia.org\/wiki\/Doi_\\(identifier\\) \"Doi (identifier)\"):[10\\.1016\/j.pcl.2005.09.009](https:\/\/doi.org\/10.1016%2Fj.pcl.2005.09.009). [ISSN](https:\/\/en.wikipedia.org\/wiki\/ISSN_\\(identifier\\) \"ISSN (identifier)\") [0031-3955](https:\/\/search.worldcat.org\/issn\/0031-3955). [PMID](https:\/\/en.wikipedia.org\/wiki\/PMID_\\(identifier\\) \"PMID (identifier)\") [16487787](https:\/\/pubmed.ncbi.nlm.nih.gov\/16487787). [S2CID](https:\/\/en.wikipedia.org\/wiki\/S2CID_\\(identifier\\) \"S2CID (identifier)\") [17103933](https:\/\/api.semanticscholar.org\/CorpusID:17103933).\n\n## External links\n\\[[edit](https:\/\/en.wikipedia.org\/w\/index.php?title=Abdominal_pain&action=edit&section=25 \"Edit section: External links\")\\]\n\n- [![](https:\/\/upload.wikimedia.org\/wikipedia\/commons\/thumb\/d\/df\/Wikibooks-logo-en-noslogan.svg\/20px-Wikibooks-logo-en-noslogan.svg.png)](https:\/\/en.wikipedia.org\/wiki\/File:Wikibooks-logo-en-noslogan.svg) [Abdominal Pain](https:\/\/en.wikibooks.org\/wiki\/Internal_Medicine\/Abdominal_Pain \"wikibooks:Internal Medicine\/Abdominal Pain\") at Wikibooks\n- [Cleveland Clinic](https:\/\/my.clevelandclinic.org\/health\/symptoms\/4167-abdominal-pain)\n- [Mayo Clinic](https:\/\/www.mayoclinic.org\/symptoms\/abdominal-pain\/basics\/definition\/sym-20050728)\n\n|   |   |\n|---|---|\n| Classification | [D](https:\/\/www.wikidata.org\/wiki\/Q183425 \"d:Q183425\") **[ICD](https:\/\/en.wikipedia.org\/wiki\/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems \"International Statistical Classification of Diseases and Related Health Problems\")\\-[11](https:\/\/en.wikipedia.org\/wiki\/ICD-11 \"ICD-11\")**: [MD81](https:\/\/icd.who.int\/browse\/latest-release\/mms\/en#1293213417) **[ICD](https:\/\/en.wikipedia.org\/wiki\/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems \"International Statistical Classification of Diseases and Related Health Problems\")\\-[10](https:\/\/en.wikipedia.org\/wiki\/ICD-10 \"ICD-10\")**: [R10](https:\/\/icd.who.int\/browse10\/2019\/en#\/R10) **[ICD](https:\/\/en.wikipedia.org\/wiki\/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems \"International Statistical Classification of Diseases and Related Health Problems\")\\-[9-CM](https:\/\/en.wikipedia.org\/wiki\/List_of_ICD-9_codes \"List of ICD-9 codes\")**: [789](http:\/\/www.icd9data.com\/getICD9Code.ashx?icd9=789) **[MeSH](https:\/\/en.wikipedia.org\/wiki\/Medical_Subject_Headings \"Medical Subject Headings\")**: [D015746](https:\/\/meshb.nlm.nih.gov\/record\/ui?ui=D015746) **[DiseasesDB](https:\/\/en.wikipedia.org\/wiki\/Diseases_Database \"Diseases Database\")**: [14367](http:\/\/www.diseasesdatabase.com\/ddb14367.htm) **[SNOMED CT](https:\/\/en.wikipedia.org\/wiki\/SNOMED_CT \"SNOMED CT\")**: [21522001](https:\/\/browser.ihtsdotools.org\/?perspective=full&conceptId1=21522001&languages=en) |\n| External resources | **[MedlinePlus](https:\/\/en.wikipedia.org\/wiki\/MedlinePlus \"MedlinePlus\")**: [003120](https:\/\/www.nlm.nih.gov\/medlineplus\/ency\/article\/003120.htm) **[Patient UK](https:\/\/en.wikipedia.org\/wiki\/Patient_UK \"Patient UK\")**: [Abdominal pain](https:\/\/patient.info\/doctor\/abdominal-pain-pro) **[Radiopaedia](https:\/\/en.wikipedia.org\/wiki\/Radiopaedia \"Radiopaedia\")**: [47481](https:\/\/radiopaedia.org\/articles\/47481) **Scholia**: [Q183425](https:\/\/tools.wmflabs.org\/scholia\/topic\/Q183425) |\n\n| [v](https:\/\/en.wikipedia.org\/wiki\/Template:Digestive_system_and_abdomen_symptoms_and_signs \"Template:Digestive system and abdomen symptoms and signs\") [t](https:\/\/en.wikipedia.org\/wiki\/Template_talk:Digestive_system_and_abdomen_symptoms_and_signs \"Template talk:Digestive system and abdomen symptoms and signs\") [e](https:\/\/en.wikipedia.org\/wiki\/Special:EditPage\/Template:Digestive_system_and_abdomen_symptoms_and_signs \"Special:EditPage\/Template:Digestive system and abdomen symptoms and signs\")[Signs and symptoms](https:\/\/en.wikipedia.org\/wiki\/Signs_and_symptoms \"Signs and symptoms\") relating to the [human digestive system](https:\/\/en.wikipedia.org\/wiki\/Human_digestive_system \"Human digestive system\"), including the [abdomen](https:\/\/en.wikipedia.org\/wiki\/Abdomen \"Abdomen\") and [eating disorders](https:\/\/en.wikipedia.org\/wiki\/Eating_disorder \"Eating disorder\") that are associated |   |\n|---|---|\n| [Gastrointestinal tract](https:\/\/en.wikipedia.org\/wiki\/Gastrointestinal_tract \"Gastrointestinal tract\") | [Nausea](https:\/\/en.wikipedia.org\/wiki\/Nausea \"Nausea\") [Vomiting](https:\/\/en.wikipedia.org\/wiki\/Vomiting \"Vomiting\") [Heartburn](https:\/\/en.wikipedia.org\/wiki\/Heartburn \"Heartburn\") [Aerophagia](https:\/\/en.wikipedia.org\/wiki\/Aerophagia \"Aerophagia\") [Dysphagia](https:\/\/en.wikipedia.org\/wiki\/Dysphagia \"Dysphagia\") [oropharyngeal](https:\/\/en.wikipedia.org\/wiki\/Oropharyngeal_dysphagia \"Oropharyngeal dysphagia\") [esophageal](https:\/\/en.wikipedia.org\/wiki\/Esophageal_dysphagia \"Esophageal dysphagia\") [Odynophagia](https:\/\/en.wikipedia.org\/wiki\/Odynophagia \"Odynophagia\") [Bad breath](https:\/\/en.wikipedia.org\/wiki\/Bad_breath \"Bad breath\") [Xerostomia](https:\/\/en.wikipedia.org\/wiki\/Xerostomia \"Xerostomia\") [Hypersalivation](https:\/\/en.wikipedia.org\/wiki\/Hypersalivation \"Hypersalivation\") [Burping](https:\/\/en.wikipedia.org\/wiki\/Burping \"Burping\") [Goodsall's rule](https:\/\/en.wikipedia.org\/wiki\/Goodsall%27s_rule \"Goodsall's rule\") [Chilaiditi syndrome](https:\/\/en.wikipedia.org\/wiki\/Chilaiditi_syndrome \"Chilaiditi syndrome\") [Dance's sign](https:\/\/en.wikipedia.org\/wiki\/Dance%27s_sign \"Dance's sign\") [Aaron's sign](https:\/\/en.wikipedia.org\/wiki\/Aaron%27s_sign \"Aaron's sign\") [Arapov's sign](https:\/\/en.wikipedia.org\/wiki\/Arapov%27s_contracture \"Arapov's contracture\") [Markle's sign](https:\/\/en.wikipedia.org\/wiki\/Markle%27s_sign \"Markle's sign\") [McBurney's point](https:\/\/en.wikipedia.org\/wiki\/McBurney%27s_point \"McBurney's point\") [Sherren's triangle](https:\/\/en.wikipedia.org\/wiki\/Sherren%27s_triangle \"Sherren's triangle\") *[Radiologic signs](https:\/\/en.wikipedia.org\/wiki\/Radiologic_sign \"Radiologic sign\"):* [Hampton's line](https:\/\/en.wikipedia.org\/wiki\/Hampton%27s_line \"Hampton's line\") [Klemm's sign](https:\/\/en.wikipedia.org\/wiki\/Klemm%27s_sign \"Klemm's sign\") |\n| Accessory | *[liver](https:\/\/en.wikipedia.org\/wiki\/Liver \"Liver\"):* [Councilman body](https:\/\/en.wikipedia.org\/wiki\/Councilman_body \"Councilman body\") [Mallory body](https:\/\/en.wikipedia.org\/wiki\/Mallory_body \"Mallory body\") *biliary:* [Boas' sign](https:\/\/en.wikipedia.org\/wiki\/Boas%27_sign \"Boas' sign\") [Courvoisier's law](https:\/\/en.wikipedia.org\/wiki\/Courvoisier%27s_law \"Courvoisier's law\") [Charcot's cholangitis triad](https:\/\/en.wikipedia.org\/wiki\/Charcot%27s_cholangitis_triad \"Charcot's cholangitis triad\")\/[Reynolds' pentad](https:\/\/en.wikipedia.org\/wiki\/Reynolds%27_pentad \"Reynolds' pentad\") *[cholecystitis](https:\/\/en.wikipedia.org\/wiki\/Cholecystitis \"Cholecystitis\")* ([Murphy's sign](https:\/\/en.wikipedia.org\/wiki\/Murphy%27s_sign \"Murphy's sign\") [Lépine's sign](https:\/\/en.wikipedia.org\/wiki\/L%C3%A9pine%27s_sign \"Lépine's sign\") [Mirizzi's syndrome](https:\/\/en.wikipedia.org\/wiki\/Mirizzi%27s_syndrome \"Mirizzi's syndrome\")) [Nardi test](https:\/\/en.wikipedia.org\/wiki\/Nardi_test \"Nardi test\") |\n| [Defecation](https:\/\/en.wikipedia.org\/wiki\/Defecation \"Defecation\") | [Flatulence](https:\/\/en.wikipedia.org\/wiki\/Flatulence \"Flatulence\") [Fecal incontinence](https:\/\/en.wikipedia.org\/wiki\/Fecal_incontinence \"Fecal incontinence\") and [encopresis](https:\/\/en.wikipedia.org\/wiki\/Encopresis \"Encopresis\") [Fecal urgency](https:\/\/en.wikipedia.org\/wiki\/Fecal_urgency \"Fecal urgency\") [Fecal occult blood](https:\/\/en.wikipedia.org\/wiki\/Fecal_occult_blood \"Fecal occult blood\") [Rectal tenesmus](https:\/\/en.wikipedia.org\/wiki\/Rectal_tenesmus \"Rectal tenesmus\") [Constipation](https:\/\/en.wikipedia.org\/wiki\/Constipation \"Constipation\") [Obstructed defecation](https:\/\/en.wikipedia.org\/wiki\/Obstructed_defecation \"Obstructed defecation\") [Diarrhea](https:\/\/en.wikipedia.org\/wiki\/Diarrhea \"Diarrhea\") [Rectal discharge](https:\/\/en.wikipedia.org\/wiki\/Rectal_discharge \"Rectal discharge\") |\n| Abdomen |   |\n|   |   |\n| Pain | [Abdominal pain]() [Acute abdomen](https:\/\/en.wikipedia.org\/wiki\/Acute_abdomen \"Acute abdomen\") [Colic](https:\/\/en.wikipedia.org\/wiki\/Colic \"Colic\") [Baby colic](https:\/\/en.wikipedia.org\/wiki\/Baby_colic \"Baby colic\") [Abdominal guarding](https:\/\/en.wikipedia.org\/wiki\/Abdominal_guarding \"Abdominal guarding\") [Blumberg's sign](https:\/\/en.wikipedia.org\/wiki\/Blumberg%27s_sign \"Blumberg's sign\") |\n| Distension | [Abdominal distension](https:\/\/en.wikipedia.org\/wiki\/Abdominal_distension \"Abdominal distension\") [Bloating](https:\/\/en.wikipedia.org\/wiki\/Bloating \"Bloating\") [Ascites](https:\/\/en.wikipedia.org\/wiki\/Ascites \"Ascites\") [Tympany](https:\/\/en.wikipedia.org\/wiki\/Tympany \"Tympany\") [Shifting dullness](https:\/\/en.wikipedia.org\/wiki\/Shifting_dullness \"Shifting dullness\") [Fluid wave test](https:\/\/en.wikipedia.org\/wiki\/Fluid_wave_test \"Fluid wave test\") |\n| Masses | [Abdominal mass](https:\/\/en.wikipedia.org\/wiki\/Abdominal_mass \"Abdominal mass\") [Hepatosplenomegaly](https:\/\/en.wikipedia.org\/wiki\/Hepatosplenomegaly \"Hepatosplenomegaly\") [Hepatomegaly](https:\/\/en.wikipedia.org\/wiki\/Hepatomegaly \"Hepatomegaly\") [Splenomegaly](https:\/\/en.wikipedia.org\/wiki\/Splenomegaly \"Splenomegaly\") |\n| Other | [Jaundice](https:\/\/en.wikipedia.org\/wiki\/Jaundice \"Jaundice\") [Mallet-Guy's sign](https:\/\/en.wikipedia.org\/wiki\/Mallet-Guy%27s_sign \"Mallet-Guy's sign\") [Puddle sign](https:\/\/en.wikipedia.org\/wiki\/Puddle_sign \"Puddle sign\") [Ballance's sign](https:\/\/en.wikipedia.org\/wiki\/Ballance%27s_sign \"Ballance's sign\") [Aortic insufficiency](https:\/\/en.wikipedia.org\/wiki\/Aortic_insufficiency \"Aortic insufficiency\") [Castell's sign](https:\/\/en.wikipedia.org\/wiki\/Castell%27s_sign \"Castell's sign\") [Kehr's sign](https:\/\/en.wikipedia.org\/wiki\/Kehr%27s_sign \"Kehr's sign\") [Cullen's sign](https:\/\/en.wikipedia.org\/wiki\/Cullen%27s_sign \"Cullen's sign\") [Grey Turner's sign](https:\/\/en.wikipedia.org\/wiki\/Grey_Turner%27s_sign \"Grey Turner's sign\") |\n| [Hernia](https:\/\/en.wikipedia.org\/wiki\/Hernia \"Hernia\") | [Howship–Romberg sign](https:\/\/en.wikipedia.org\/wiki\/Howship%E2%80%93Romberg_sign \"Howship–Romberg sign\") [Hannington-Kiff sign](https:\/\/en.wikipedia.org\/wiki\/Hannington-Kiff_sign \"Hannington-Kiff sign\") |\n| Other | [Psoas sign](https:\/\/en.wikipedia.org\/wiki\/Psoas_sign \"Psoas sign\") [Obturator sign](https:\/\/en.wikipedia.org\/wiki\/Obturator_sign \"Obturator sign\") [Rovsing's sign](https:\/\/en.wikipedia.org\/wiki\/Rovsing%27s_sign \"Rovsing's sign\") [Hamburger sign](https:\/\/en.wikipedia.org\/wiki\/Hamburger_sign \"Hamburger sign\") [Heel tap sign](https:\/\/en.wikipedia.org\/wiki\/Heel_tap_sign \"Heel tap sign\") [Aure-Rozanova's sign](https:\/\/en.wikipedia.org\/wiki\/Aure-Rozanova%27s_sign \"Aure-Rozanova's sign\") [Dunphy's sign](https:\/\/en.wikipedia.org\/wiki\/Dunphy%27s_sign \"Dunphy's sign\") [Alder's sign](https:\/\/en.wikipedia.org\/wiki\/Alder%27s_sign \"Alder's sign\") [Lockwood's sign](https:\/\/en.wikipedia.org\/wiki\/Lockwood%27s_sign \"Lockwood's sign\") [Rosenstein's sign](https:\/\/en.wikipedia.org\/wiki\/Rosenstein%27s_sign \"Rosenstein's sign\") [Cupola sign](https:\/\/en.wikipedia.org\/wiki\/Cupola_sign \"Cupola sign\") [Fothergill's sign](https:\/\/en.wikipedia.org\/wiki\/Fothergill%27s_sign \"Fothergill's sign\") [Carnett's sign](https:\/\/en.wikipedia.org\/wiki\/Carnett%27s_sign \"Carnett's sign\") [Massouh's sign](https:\/\/en.wikipedia.org\/wiki\/Massouh%27s_sign \"Massouh's sign\") [Sister Mary Joseph nodule](https:\/\/en.wikipedia.org\/wiki\/Sister_Mary_Joseph_nodule \"Sister Mary Joseph nodule\") [Blumer's shelf](https:\/\/en.wikipedia.org\/wiki\/Blumer%27s_shelf \"Blumer's shelf\") |\n| Eating disorders | [Anorexia](https:\/\/en.wikipedia.org\/wiki\/Anorexia_\\(symptom\\) \"Anorexia (symptom)\") [Anorexia nervosa](https:\/\/en.wikipedia.org\/wiki\/Anorexia_nervosa \"Anorexia nervosa\") [Bulimia nervosa](https:\/\/en.wikipedia.org\/wiki\/Bulimia_nervosa \"Bulimia nervosa\") [Binge eating disorder](https:\/\/en.wikipedia.org\/wiki\/Binge_eating_disorder \"Binge eating disorder\") [A\/RFID](https:\/\/en.wikipedia.org\/wiki\/Avoidant\/restrictive_food_intake_disorder \"Avoidant\/restrictive food intake disorder\") [Pica](https:\/\/en.wikipedia.org\/wiki\/Pica_\\(disorder\\) \"Pica (disorder)\") [Trichophagia](https:\/\/en.wikipedia.org\/wiki\/Trichophagia \"Trichophagia\") [Pagophagia](https:\/\/en.wikipedia.org\/wiki\/Pagophagia \"Pagophagia\") [Geophagia](https:\/\/en.wikipedia.org\/wiki\/Geophagia \"Geophagia\") |\n\n|   |   |\n|---|---|\n| [Authority control databases](https:\/\/en.wikipedia.org\/wiki\/Help:Authority_control \"Help:Authority control\"): National [![Edit this at Wikidata](https:\/\/upload.wikimedia.org\/wikipedia\/en\/thumb\/8\/8a\/OOjs_UI_icon_edit-ltr-progressive.svg\/20px-OOjs_UI_icon_edit-ltr-progressive.svg.png)](https:\/\/www.wikidata.org\/wiki\/Q183425#identifiers \"Edit this at Wikidata\") | [Japan](https:\/\/id.ndl.go.jp\/auth\/ndlna\/00563653) [Czech Republic](https:\/\/aleph.nkp.cz\/F\/?func=find-c&local_base=aut&ccl_term=ica=ph207456&CON_LNG=ENG) [Israel](https:\/\/www.nli.org.il\/en\/authorities\/987007292974105171) |\n\n![](https:\/\/en.wikipedia.org\/wiki\/Special:CentralAutoLogin\/start?useformat=desktop&type=1x1&usesul3=1)\n\nRetrieved from \"<https:\/\/en.wikipedia.org\/w\/index.php?title=Abdominal_pain&oldid=1332890343>\"\n\n[Categories](https:\/\/en.wikipedia.org\/wiki\/Help:Category \"Help:Category\"):\n\n- [Abdominal pain](https:\/\/en.wikipedia.org\/wiki\/Category:Abdominal_pain \"Category:Abdominal pain\")\n- [Symptoms and signs: Digestive system and abdomen](https:\/\/en.wikipedia.org\/wiki\/Category:Symptoms_and_signs:_Digestive_system_and_abdomen \"Category:Symptoms and signs: Digestive system and abdomen\")\n- [Acute pain](https:\/\/en.wikipedia.org\/wiki\/Category:Acute_pain \"Category:Acute pain\")\n- [Pain](https:\/\/en.wikipedia.org\/wiki\/Category:Pain \"Category:Pain\")\n\nHidden categories:\n\n- [Articles with short description](https:\/\/en.wikipedia.org\/wiki\/Category:Articles_with_short_description \"Category:Articles with short description\")\n- [Short description is different from Wikidata](https:\/\/en.wikipedia.org\/wiki\/Category:Short_description_is_different_from_Wikidata \"Category:Short description is different from Wikidata\")\n- [Use dmy dates from December 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Wikipedia® is a registered trademark of the [Wikimedia Foundation, Inc.](https:\/\/wikimediafoundation.org\/), a non-profit organization.\n\n- [Privacy policy](https:\/\/foundation.wikimedia.org\/wiki\/Special:MyLanguage\/Policy:Privacy_policy)\n- [About Wikipedia](https:\/\/en.wikipedia.org\/wiki\/Wikipedia:About)\n- [Disclaimers](https:\/\/en.wikipedia.org\/wiki\/Wikipedia:General_disclaimer)\n- [Contact Wikipedia](https:\/\/en.wikipedia.org\/wiki\/Wikipedia:Contact_us)\n- [Legal & safety contacts](https:\/\/foundation.wikimedia.org\/wiki\/Special:MyLanguage\/Legal:Wikimedia_Foundation_Legal_and_Safety_Contact_Information)\n- [Code of Conduct](https:\/\/foundation.wikimedia.org\/wiki\/Special:MyLanguage\/Policy:Universal_Code_of_Conduct)\n- [Developers](https:\/\/developer.wikimedia.org\/)\n- [Statistics](https:\/\/stats.wikimedia.org\/#\/en.wikipedia.org)\n- [Cookie statement](https:\/\/foundation.wikimedia.org\/wiki\/Special:MyLanguage\/Policy:Cookie_statement)\n- [Mobile view](https:\/\/en.wikipedia.org\/w\/index.php?title=Abdominal_pain&mobileaction=toggle_view_mobile)\n\n- [![Wikimedia Foundation](https:\/\/en.wikipedia.org\/static\/images\/footer\/wikimedia.svg)](https:\/\/www.wikimedia.org\/)\n- [![Powered by MediaWiki](https:\/\/en.wikipedia.org\/w\/resources\/assets\/mediawiki_compact.svg)](https:\/\/www.mediawiki.org\/)\n\nSearch\n\nToggle the table of contents\n\nAbdominal pain\n\n52 languages\n\n[Add topic](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain)","attrs_readable_markdown":"From Wikipedia, the free encyclopedia\n\n\"Stomach ache\" redirects here. For the 2014 album by Frank Iero, see [Stomachaches (album)](https:\/\/en.wikipedia.org\/wiki\/Stomachaches_\\(album\\) \"Stomachaches (album)\").\n\n| Abdominal pain |   |\n|---|---|\n| Other names | Stomach ache, tummy ache, belly ache, belly pain, gastralgia, stomach pain |\n| [![](https:\/\/upload.wikimedia.org\/wikipedia\/commons\/thumb\/f\/f0\/Gray1220.svg\/250px-Gray1220.svg.png)](https:\/\/en.wikipedia.org\/wiki\/File:Gray1220.svg) |   |\n| Abdominal pain can be characterized by the region it affects. |   |\n| [Specialty](https:\/\/en.wikipedia.org\/wiki\/Medical_specialty \"Medical specialty\") | [Gastroenterology](https:\/\/en.wikipedia.org\/wiki\/Gastroenterology \"Gastroenterology\"), [general surgery](https:\/\/en.wikipedia.org\/wiki\/General_surgery \"General surgery\") |\n| [Complications](https:\/\/en.wikipedia.org\/wiki\/Complication_\\(medicine\\) \"Complication (medicine)\") | [Anorexia](https:\/\/en.wikipedia.org\/wiki\/Anorexia_\\(symptom\\) \"Anorexia (symptom)\") |\n| [Causes](https:\/\/en.wikipedia.org\/wiki\/Cause_\\(medicine\\) \"Cause (medicine)\") | **Serious**: [Appendicitis](https:\/\/en.wikipedia.org\/wiki\/Appendicitis \"Appendicitis\"), perforated [stomach ulcer](https:\/\/en.wikipedia.org\/wiki\/Stomach_ulcer \"Stomach ulcer\"), [pancreatitis](https:\/\/en.wikipedia.org\/wiki\/Pancreatitis \"Pancreatitis\"), ruptured [diverticulitis](https:\/\/en.wikipedia.org\/wiki\/Diverticulitis \"Diverticulitis\"), [ovarian torsion](https:\/\/en.wikipedia.org\/wiki\/Ovarian_torsion \"Ovarian torsion\"), [volvulus](https:\/\/en.wikipedia.org\/wiki\/Volvulus \"Volvulus\"), ruptured [aortic aneurysm](https:\/\/en.wikipedia.org\/wiki\/Aortic_aneurysm \"Aortic aneurysm\"), [lacerated spleen](https:\/\/en.wikipedia.org\/wiki\/Lacerated_spleen \"Lacerated spleen\") or liver, [ischemic colitis](https:\/\/en.wikipedia.org\/wiki\/Ischemic_colitis \"Ischemic colitis\"), [ischaemic myocardial conditions](https:\/\/en.wikipedia.org\/w\/index.php?title=Ischaemic_myocardial_conditions&action=edit&redlink=1 \"Ischaemic myocardial conditions (page does not exist)\")[\\[1\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Stat2018-1) **Common**: [Gastroenteritis](https:\/\/en.wikipedia.org\/wiki\/Gastroenteritis \"Gastroenteritis\"), [irritable bowel syndrome](https:\/\/en.wikipedia.org\/wiki\/Irritable_bowel_syndrome \"Irritable bowel syndrome\")[\\[2\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Vin2014-2) |\n\n**Abdominal pain**, also known as a **stomach ache**, is a [symptom](https:\/\/en.wikipedia.org\/wiki\/Symptom \"Symptom\") associated with both non-serious and serious medical issues. Since the abdomen contains most of the body's vital organs, it can be an indicator of a wide variety of diseases. Given that, approaching the examination of a person and planning of a [differential diagnosis](https:\/\/en.wikipedia.org\/wiki\/Differential_diagnosis \"Differential diagnosis\") is extremely important.[\\[3\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Hopcroft2020-3)\n\nCommon causes of [pain](https:\/\/en.wikipedia.org\/wiki\/Pain \"Pain\") in the [abdomen](https:\/\/en.wikipedia.org\/wiki\/Abdomen \"Abdomen\") include [gastroenteritis](https:\/\/en.wikipedia.org\/wiki\/Gastroenteritis \"Gastroenteritis\") and [irritable bowel syndrome](https:\/\/en.wikipedia.org\/wiki\/Irritable_bowel_syndrome \"Irritable bowel syndrome\").[\\[3\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Hopcroft2020-3) About 15% of people have a more serious underlying condition such as [appendicitis](https:\/\/en.wikipedia.org\/wiki\/Appendicitis \"Appendicitis\"), leaking or ruptured [abdominal aortic aneurysm](https:\/\/en.wikipedia.org\/wiki\/Abdominal_aortic_aneurysm \"Abdominal aortic aneurysm\"), [diverticulitis](https:\/\/en.wikipedia.org\/wiki\/Diverticulitis \"Diverticulitis\"), or [ectopic pregnancy](https:\/\/en.wikipedia.org\/wiki\/Ectopic_pregnancy \"Ectopic pregnancy\").[\\[2\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Vin2014-2) In a third of cases, the exact cause is unclear.[\\[2\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Vin2014-2)\n\nThe onset of abdominal pain can be abrupt, quick, or gradual. Sudden onset pain happens in a split second. Rapidly onset pain starts mild and gets worse over the next few minutes. Pain that gradually intensifies only after several hours or even days has passed is referred to as gradual onset pain.[\\[4\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Sherman_1990_r770-4)\n\nOne can describe abdominal pain as either continuous or sporadic and as [cramping](https:\/\/en.wikipedia.org\/wiki\/Cramp \"Cramp\"), dull, or aching. The characteristic of cramping abdominal pain is that it comes in brief waves, builds to a peak, and then abruptly stops for a period during which there is no more pain. The pain flares up and off periodically. The most common cause of persistent dull or aching abdominal pain is edema or distention of the wall of a hollow viscus. A dull or aching pain may also be felt due to a stretch in the liver and spleen capsules.[\\[4\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Sherman_1990_r770-4)\n\nThe most frequent reasons for abdominal pain are [gastroenteritis](https:\/\/en.wikipedia.org\/wiki\/Gastroenteritis \"Gastroenteritis\") (13%), [irritable bowel syndrome](https:\/\/en.wikipedia.org\/wiki\/Irritable_bowel_syndrome \"Irritable bowel syndrome\") (8%), urinary tract problems (5%), [inflammation of the stomach](https:\/\/en.wikipedia.org\/wiki\/Gastritis \"Gastritis\") (5%) and [constipation](https:\/\/en.wikipedia.org\/wiki\/Constipation \"Constipation\") (5%). In about 30% of cases, the cause is not determined. About 10% of cases have a more serious cause including gallbladder ([gallstones](https:\/\/en.wikipedia.org\/wiki\/Gallstone \"Gallstone\") or [biliary dyskinesia](https:\/\/en.wikipedia.org\/wiki\/Biliary_dyskinesia \"Biliary dyskinesia\")) or [pancreas](https:\/\/en.wikipedia.org\/wiki\/Pancreas \"Pancreas\") problems (4%), [diverticulitis](https:\/\/en.wikipedia.org\/wiki\/Diverticulitis \"Diverticulitis\") (3%), [appendicitis](https:\/\/en.wikipedia.org\/wiki\/Appendicitis \"Appendicitis\") (2%) and [cancer](https:\/\/en.wikipedia.org\/wiki\/Cancer \"Cancer\") (1%).[\\[2\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Vin2014-2) More common in those who are older, [ischemic colitis](https:\/\/en.wikipedia.org\/wiki\/Ischemic_colitis \"Ischemic colitis\"),[\\[5\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-5) [mesenteric ischemia](https:\/\/en.wikipedia.org\/wiki\/Mesenteric_ischemia \"Mesenteric ischemia\"), and [abdominal aortic aneurysms](https:\/\/en.wikipedia.org\/wiki\/Abdominal_aortic_aneurysm \"Abdominal aortic aneurysm\") are other serious causes.[\\[6\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Spangler_2014-6)\n\n[Acute abdomen](https:\/\/en.wikipedia.org\/wiki\/Acute_abdomen \"Acute abdomen\") is a condition where there is a sudden onset of severe abdominal pain requiring immediate recognition and management of the underlying cause.[\\[7\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-aa-7) The underlying cause may involve infection, [inflammation](https:\/\/en.wikipedia.org\/wiki\/Inflammation \"Inflammation\"), [vascular occlusion](https:\/\/en.wikipedia.org\/wiki\/Vascular_occlusion \"Vascular occlusion\") or bowel obstruction.[\\[7\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-aa-7)\n\nThe pain may elicit [nausea](https:\/\/en.wikipedia.org\/wiki\/Nausea \"Nausea\") and [vomiting](https:\/\/en.wikipedia.org\/wiki\/Vomiting \"Vomiting\"), [abdominal distention](https:\/\/en.wikipedia.org\/wiki\/Abdominal_distention \"Abdominal distention\"), [fever](https:\/\/en.wikipedia.org\/wiki\/Fever \"Fever\") and signs of [shock](https:\/\/en.wikipedia.org\/wiki\/Shock_\\(circulatory\\) \"Shock (circulatory)\").[\\[7\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-aa-7) A common condition associated with acute abdominal pain is [appendicitis](https:\/\/en.wikipedia.org\/wiki\/Appendicitis \"Appendicitis\").[\\[8\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-8) Here is a list of acute abdomen causes:\n\n|   |   |\n|---|---|\n| Surgical causes \\[[edit](https:\/\/en.wikipedia.org\/w\/index.php?title=Abdominal_pain&action=edit&section=4 \"Edit section: Surgical causes\")\\] | Source:[\\[7\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-aa-7) Inflammatory \\[[edit](https:\/\/en.wikipedia.org\/w\/index.php?title=Abdominal_pain&action=edit&section=5 \"Edit section: Inflammatory\")\\] Infections such as [appendicitis](https:\/\/en.wikipedia.org\/wiki\/Appendicitis \"Appendicitis\"), [cholecystitis](https:\/\/en.wikipedia.org\/wiki\/Cholecystitis \"Cholecystitis\"), [pancreatitis](https:\/\/en.wikipedia.org\/wiki\/Pancreatitis \"Pancreatitis\"), [pyelonephritis](https:\/\/en.wikipedia.org\/wiki\/Pyelonephritis \"Pyelonephritis\"), [Peritonitis](https:\/\/en.wikipedia.org\/wiki\/Peritonitis \"Peritonitis\"), [pelvic inflammatory disease](https:\/\/en.wikipedia.org\/wiki\/Pelvic_inflammatory_disease \"Pelvic inflammatory disease\"), [hepatitis](https:\/\/en.wikipedia.org\/wiki\/Hepatitis \"Hepatitis\"), [mesenteric adenitis](https:\/\/en.wikipedia.org\/wiki\/Mesenteric_adenitis \"Mesenteric adenitis\"), or a subdiaphragmatic [abscess](https:\/\/en.wikipedia.org\/wiki\/Abscess \"Abscess\"). [Perforation](https:\/\/en.wikipedia.org\/wiki\/Gastrointestinal_perforation \"Gastrointestinal perforation\") of a [peptic ulcer](https:\/\/en.wikipedia.org\/wiki\/Peptic_ulcer \"Peptic ulcer\"), a [diverticulum](https:\/\/en.wikipedia.org\/wiki\/Diverticulitis \"Diverticulitis\"), or the [caecum](https:\/\/en.wikipedia.org\/wiki\/Caecum \"Caecum\"). Complications of [inflammatory bowel disease](https:\/\/en.wikipedia.org\/wiki\/Inflammatory_bowel_disease \"Inflammatory bowel disease\"), such as [Crohn's disease](https:\/\/en.wikipedia.org\/wiki\/Crohn%27s_disease \"Crohn's disease\") or [ulcerative colitis](https:\/\/en.wikipedia.org\/wiki\/Ulcerative_colitis \"Ulcerative colitis\"). Mechanical \\[[edit](https:\/\/en.wikipedia.org\/w\/index.php?title=Abdominal_pain&action=edit&section=6 \"Edit section: Mechanical\")\\] [Small bowel](https:\/\/en.wikipedia.org\/wiki\/Small_bowel \"Small bowel\") [obstruction](https:\/\/en.wikipedia.org\/wiki\/Bowel_obstruction \"Bowel obstruction\") secondary to adhesions caused by previous surgeries, [intussusception](https:\/\/en.wikipedia.org\/wiki\/Intussusception_\\(medical_disorder\\) \"Intussusception (medical disorder)\"), [hernias](https:\/\/en.wikipedia.org\/wiki\/Hernia \"Hernia\"), benign or malignant [neoplasms](https:\/\/en.wikipedia.org\/wiki\/Neoplasia \"Neoplasia\"). [Large bowel](https:\/\/en.wikipedia.org\/wiki\/Large_bowel \"Large bowel\") [obstruction](https:\/\/en.wikipedia.org\/wiki\/Bowel_obstruction \"Bowel obstruction\") caused by [colorectal cancer](https:\/\/en.wikipedia.org\/wiki\/Colorectal_cancer \"Colorectal cancer\"), [inflammatory bowel disease](https:\/\/en.wikipedia.org\/wiki\/Inflammatory_bowel_disease \"Inflammatory bowel disease\"), [volvulus](https:\/\/en.wikipedia.org\/wiki\/Volvulus \"Volvulus\"), [fecal impaction](https:\/\/en.wikipedia.org\/wiki\/Fecal_impaction \"Fecal impaction\"), or [hernia](https:\/\/en.wikipedia.org\/wiki\/Hernia \"Hernia\"). Vascular \\[[edit](https:\/\/en.wikipedia.org\/w\/index.php?title=Abdominal_pain&action=edit&section=7 \"Edit section: Vascular\")\\] occlusive [intestinal ischemia](https:\/\/en.wikipedia.org\/wiki\/Intestinal_ischemia \"Intestinal ischemia\"), usually caused by [thromboembolism](https:\/\/en.wikipedia.org\/wiki\/Thromboembolism \"Thromboembolism\") of the [superior Mesenteric artery.](https:\/\/en.wikipedia.org\/wiki\/Superior_mesenteric_artery \"Superior mesenteric artery\") [Referred pain](https:\/\/en.wikipedia.org\/wiki\/Referred_pain \"Referred pain\") \\[[edit](https:\/\/en.wikipedia.org\/w\/index.php?title=Abdominal_pain&action=edit&section=8 \"Edit section: Referred pain\")\\] Source:[\\[9\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-9) Viscero-visceral referral: happens when one organ with afferent nerves close to another organ is sensitized or inflamed (in this case any of the abdominal viscera)[\\[10\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-10) Viscero-somatic referral: any pain in the viscera that causes pain in the muscle, bone, and skin (of the abdomen in case of abdominal pain) Somatic-visceral referral: pain in the skin, muscles, and bone that causes referred pain in the viscera (of the abdomen such as the stomach, kidneys, bladder, etc.) |\n| Medical causes \\[[edit](https:\/\/en.wikipedia.org\/w\/index.php?title=Abdominal_pain&action=edit&section=9 \"Edit section: Medical causes\")\\] | Source:[\\[7\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-aa-7)[Acute pancreatitis](https:\/\/en.wikipedia.org\/wiki\/Acute_pancreatitis \"Acute pancreatitis\").[Sickle cell anemia](https:\/\/en.wikipedia.org\/wiki\/Sickle_cell_disease \"Sickle cell disease\").[Diabetic ketoacidosis](https:\/\/en.wikipedia.org\/wiki\/Diabetic_ketoacidosis \"Diabetic ketoacidosis\") (DKA).[Adrenal crisis](https:\/\/en.wikipedia.org\/wiki\/Adrenal_crisis \"Adrenal crisis\").[Pyelonephritis](https:\/\/en.wikipedia.org\/wiki\/Pyelonephritis \"Pyelonephritis\").[Lead poisoning](https:\/\/en.wikipedia.org\/wiki\/Lead_poisoning \"Lead poisoning\").[Familial Mediterranean fever](https:\/\/en.wikipedia.org\/wiki\/Familial_Mediterranean_fever \"Familial Mediterranean fever\") (FMF). |\n| Gynecological causes \\[[edit](https:\/\/en.wikipedia.org\/w\/index.php?title=Abdominal_pain&action=edit&section=10 \"Edit section: Gynecological causes\")\\] | Source:[\\[11\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-11)[Pelvic inflammatory disease](https:\/\/en.wikipedia.org\/wiki\/Pelvic_inflammatory_disease \"Pelvic inflammatory disease\") (PID) and abscess.[Ectopic pregnancy](https:\/\/en.wikipedia.org\/wiki\/Ectopic_pregnancy \"Ectopic pregnancy\").Hemorrhagic [ovarian cyst](https:\/\/en.wikipedia.org\/wiki\/Ovarian_cyst \"Ovarian cyst\").Adnexal or [ovarian torsion](https:\/\/en.wikipedia.org\/wiki\/Ovarian_torsion \"Ovarian torsion\"). |\n\nA more extensive list includes the following:\\[*[citation needed](https:\/\/en.wikipedia.org\/wiki\/Wikipedia:Citation_needed \"Wikipedia:Citation needed\")*\\]\n\n- Gastrointestinal\n  - GI tract\n    - Inflammatory: [gastroenteritis](https:\/\/en.wikipedia.org\/wiki\/Gastroenteritis \"Gastroenteritis\"), [appendicitis](https:\/\/en.wikipedia.org\/wiki\/Appendicitis \"Appendicitis\"), [gastritis](https:\/\/en.wikipedia.org\/wiki\/Gastritis \"Gastritis\"), [esophagitis](https:\/\/en.wikipedia.org\/wiki\/Esophagitis \"Esophagitis\"), [diverticulitis](https:\/\/en.wikipedia.org\/wiki\/Diverticulitis \"Diverticulitis\"), [Crohn's disease](https:\/\/en.wikipedia.org\/wiki\/Crohn%27s_disease \"Crohn's disease\"), [ulcerative colitis](https:\/\/en.wikipedia.org\/wiki\/Ulcerative_colitis \"Ulcerative colitis\"), [microscopic colitis](https:\/\/en.wikipedia.org\/wiki\/Microscopic_colitis \"Microscopic colitis\")\n    - Obstruction: [hernia](https:\/\/en.wikipedia.org\/wiki\/Hernia \"Hernia\"), [intussusception](https:\/\/en.wikipedia.org\/wiki\/Intussusception_\\(medical_disorder\\) \"Intussusception (medical disorder)\"), [volvulus](https:\/\/en.wikipedia.org\/wiki\/Volvulus \"Volvulus\"), post-surgical [adhesions](https:\/\/en.wikipedia.org\/wiki\/Adhesions \"Adhesions\"), [tumors](https:\/\/en.wikipedia.org\/wiki\/Tumor \"Tumor\"), severe [constipation](https:\/\/en.wikipedia.org\/wiki\/Constipation \"Constipation\"), [hemorrhoids](https:\/\/en.wikipedia.org\/wiki\/Hemorrhoids \"Hemorrhoids\")\n    - Vascular: [embolism](https:\/\/en.wikipedia.org\/wiki\/Embolism \"Embolism\"), [thrombosis](https:\/\/en.wikipedia.org\/wiki\/Thrombosis \"Thrombosis\"), [hemorrhage](https:\/\/en.wikipedia.org\/wiki\/Hemorrhage \"Hemorrhage\"), [sickle cell disease](https:\/\/en.wikipedia.org\/wiki\/Sickle_cell_disease \"Sickle cell disease\"), [abdominal angina](https:\/\/en.wikipedia.org\/wiki\/Abdominal_angina \"Abdominal angina\"), blood vessel compression (such as celiac artery compression syndrome), [superior mesenteric artery syndrome](https:\/\/en.wikipedia.org\/wiki\/Superior_mesenteric_artery_syndrome \"Superior mesenteric artery syndrome\"), [postural orthostatic tachycardia syndrome](https:\/\/en.wikipedia.org\/wiki\/Postural_orthostatic_tachycardia_syndrome \"Postural orthostatic tachycardia syndrome\")\n    - [Digestive](https:\/\/en.wikipedia.org\/wiki\/Digestion \"Digestion\"): [peptic ulcer](https:\/\/en.wikipedia.org\/wiki\/Peptic_ulcer \"Peptic ulcer\"), [lactose intolerance](https:\/\/en.wikipedia.org\/wiki\/Lactose_intolerance \"Lactose intolerance\"), [celiac disease](https:\/\/en.wikipedia.org\/wiki\/Coeliac_disease \"Coeliac disease\"), [food allergies](https:\/\/en.wikipedia.org\/wiki\/Food_allergies \"Food allergies\"), [indigestion](https:\/\/en.wikipedia.org\/wiki\/Indigestion \"Indigestion\")\n  - Glands\n    - Bile system\n      - Inflammatory: [cholecystitis](https:\/\/en.wikipedia.org\/wiki\/Cholecystitis \"Cholecystitis\"), [cholangitis](https:\/\/en.wikipedia.org\/wiki\/Cholangitis \"Cholangitis\")\n      - Obstruction: [cholelithiasis](https:\/\/en.wikipedia.org\/wiki\/Cholelithiasis \"Cholelithiasis\")\n    - Liver\n      - Inflammatory: [hepatitis](https:\/\/en.wikipedia.org\/wiki\/Hepatitis \"Hepatitis\"), [liver abscess](https:\/\/en.wikipedia.org\/wiki\/Liver_abscess \"Liver abscess\")\n    - Pancreatic\n      - Inflammatory: [pancreatitis](https:\/\/en.wikipedia.org\/wiki\/Pancreatitis \"Pancreatitis\")\n- Renal and urological\n  - Inflammation: [pyelonephritis](https:\/\/en.wikipedia.org\/wiki\/Pyelonephritis \"Pyelonephritis\"), [bladder infection](https:\/\/en.wikipedia.org\/wiki\/Cystitis \"Cystitis\")\n  - Obstruction: [kidney stones](https:\/\/en.wikipedia.org\/wiki\/Nephrolithiasis \"Nephrolithiasis\"), [urolithiasis](https:\/\/en.wikipedia.org\/wiki\/Urolithiasis \"Urolithiasis\"), [urinary retention](https:\/\/en.wikipedia.org\/wiki\/Urinary_retention \"Urinary retention\")\n  - Vascular: [left renal vein entrapment](https:\/\/en.wikipedia.org\/wiki\/Left_renal_vein_entrapment \"Left renal vein entrapment\")\n- Gynaecological or obstetric\n  - Inflammatory: [pelvic inflammatory disease](https:\/\/en.wikipedia.org\/wiki\/Pelvic_inflammatory_disease \"Pelvic inflammatory disease\")\n  - Mechanical: [ovarian torsion](https:\/\/en.wikipedia.org\/wiki\/Ovarian_torsion \"Ovarian torsion\")\n  - Endocrinological: [menstruation](https:\/\/en.wikipedia.org\/wiki\/Menstruation \"Menstruation\"), [Mittelschmerz](https:\/\/en.wikipedia.org\/wiki\/Mittelschmerz \"Mittelschmerz\")\n  - Tumors: [endometriosis](https:\/\/en.wikipedia.org\/wiki\/Endometriosis \"Endometriosis\"), [fibroids](https:\/\/en.wikipedia.org\/wiki\/Fibroma \"Fibroma\"), [ovarian cyst](https:\/\/en.wikipedia.org\/wiki\/Ovarian_cyst \"Ovarian cyst\"), [ovarian cancer](https:\/\/en.wikipedia.org\/wiki\/Ovarian_cancer \"Ovarian cancer\")\n  - Pregnancy: ruptured [ectopic pregnancy](https:\/\/en.wikipedia.org\/wiki\/Ectopic_pregnancy \"Ectopic pregnancy\"), [threatened abortion](https:\/\/en.wikipedia.org\/wiki\/Threatened_abortion \"Threatened abortion\")\n- [Abdominal wall](https:\/\/en.wikipedia.org\/wiki\/Abdominal_wall \"Abdominal wall\")\n  - muscle strain or trauma\n  - muscular infection\n  - [neurogenic](https:\/\/en.wikipedia.org\/wiki\/Neurogenic \"Neurogenic\") pain: [herpes zoster](https:\/\/en.wikipedia.org\/wiki\/Herpes_zoster \"Herpes zoster\"), [radiculitis](https:\/\/en.wikipedia.org\/wiki\/Radiculitis \"Radiculitis\") in [Lyme disease](https:\/\/en.wikipedia.org\/wiki\/Lyme_disease \"Lyme disease\"), [abdominal cutaneous nerve entrapment syndrome](https:\/\/en.wikipedia.org\/wiki\/Anterior_cutaneous_nerve_entrapment_syndrome \"Anterior cutaneous nerve entrapment syndrome\") (ACNES), [tabes dorsalis](https:\/\/en.wikipedia.org\/wiki\/Tabes_dorsalis \"Tabes dorsalis\")\n- [Referred pain](https:\/\/en.wikipedia.org\/wiki\/Referred_pain \"Referred pain\")\n  - from the [thorax](https:\/\/en.wikipedia.org\/wiki\/Thorax \"Thorax\"): [pneumonia](https:\/\/en.wikipedia.org\/wiki\/Pneumonia \"Pneumonia\"), [pulmonary embolism](https:\/\/en.wikipedia.org\/wiki\/Pulmonary_embolism \"Pulmonary embolism\"), [ischemic heart disease](https:\/\/en.wikipedia.org\/wiki\/Ischemic_heart_disease \"Ischemic heart disease\"), [pericarditis](https:\/\/en.wikipedia.org\/wiki\/Pericarditis \"Pericarditis\")\n  - from the [spine](https:\/\/en.wikipedia.org\/wiki\/Vertebral_column \"Vertebral column\"): [radiculitis](https:\/\/en.wikipedia.org\/wiki\/Radiculitis \"Radiculitis\")\n  - from the [genitals](https:\/\/en.wikipedia.org\/wiki\/Genitals \"Genitals\"): [testicular torsion](https:\/\/en.wikipedia.org\/wiki\/Testicular_torsion \"Testicular torsion\")\n- [Metabolic disturbance](https:\/\/en.wikipedia.org\/wiki\/Metabolic_disturbance \"Metabolic disturbance\")\n  - [uremia](https:\/\/en.wikipedia.org\/wiki\/Uremia \"Uremia\"), [diabetic ketoacidosis](https:\/\/en.wikipedia.org\/wiki\/Diabetic_ketoacidosis \"Diabetic ketoacidosis\"), [porphyria](https:\/\/en.wikipedia.org\/wiki\/Porphyria \"Porphyria\"), [C1-esterase inhibitor deficiency](https:\/\/en.wikipedia.org\/wiki\/C1-esterase_inhibitor_deficiency \"C1-esterase inhibitor deficiency\"), adrenal insufficiency, [lead poisoning](https:\/\/en.wikipedia.org\/wiki\/Lead_poisoning \"Lead poisoning\"), [black widow spider](https:\/\/en.wikipedia.org\/wiki\/Latrodectus \"Latrodectus\") bite, [narcotic](https:\/\/en.wikipedia.org\/wiki\/Narcotic \"Narcotic\") [withdrawal](https:\/\/en.wikipedia.org\/wiki\/Drug_withdrawal \"Drug withdrawal\")\n- Blood vessels\n  - [aortic dissection](https:\/\/en.wikipedia.org\/wiki\/Aortic_dissection \"Aortic dissection\"), [abdominal aortic aneurysm](https:\/\/en.wikipedia.org\/wiki\/Abdominal_aortic_aneurysm \"Abdominal aortic aneurysm\")\n- Immune system\n  - [sarcoidosis](https:\/\/en.wikipedia.org\/wiki\/Sarcoidosis \"Sarcoidosis\")\n  - [vasculitis](https:\/\/en.wikipedia.org\/wiki\/Vasculitis \"Vasculitis\")\n  - [familial Mediterranean fever](https:\/\/en.wikipedia.org\/wiki\/Familial_Mediterranean_fever \"Familial Mediterranean fever\")\n- Idiopathic\n  - [irritable bowel syndrome](https:\/\/en.wikipedia.org\/wiki\/Irritable_bowel_syndrome \"Irritable bowel syndrome\") (IBS) (affecting up to 20% of the population, IBS is the most common cause of recurrent and intermittent abdominal pain)\n\nThe location of abdominal pain can provide information about what may be causing the pain. The abdomen can be divided into four regions called quadrants. Locations and associated conditions include:[\\[12\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-12)[\\[13\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-13)\n\n- Diffuse\n  - [Peritonitis](https:\/\/en.wikipedia.org\/wiki\/Peritonitis \"Peritonitis\")\n  - Vascular: [mesenteric ischemia](https:\/\/en.wikipedia.org\/wiki\/Mesenteric_ischemia \"Mesenteric ischemia\"), [ischemic colitis](https:\/\/en.wikipedia.org\/wiki\/Ischemic_colitis \"Ischemic colitis\"), [Henoch-Schonlein purpura](https:\/\/en.wikipedia.org\/wiki\/Henoch%E2%80%93Sch%C3%B6nlein_purpura \"Henoch–Schönlein purpura\"), [sickle cell disease](https:\/\/en.wikipedia.org\/wiki\/Sickle_cell_disease \"Sickle cell disease\"), [systemic lupus erythematosus](https:\/\/en.wikipedia.org\/wiki\/Systemic_lupus_erythematosus \"Systemic lupus erythematosus\"), [polyarteritis nodosa](https:\/\/en.wikipedia.org\/wiki\/Polyarteritis_nodosa \"Polyarteritis nodosa\")\n  - Small [bowel obstruction](https:\/\/en.wikipedia.org\/wiki\/Bowel_obstruction \"Bowel obstruction\")\n  - [Irritable bowel syndrome](https:\/\/en.wikipedia.org\/wiki\/Irritable_bowel_syndrome \"Irritable bowel syndrome\")\n  - [Metabolic disorders](https:\/\/en.wikipedia.org\/wiki\/Metabolic_disorder \"Metabolic disorder\"): [ketoacidosis](https:\/\/en.wikipedia.org\/wiki\/Ketoacidosis \"Ketoacidosis\"), [porphyria](https:\/\/en.wikipedia.org\/wiki\/Porphyria \"Porphyria\"), [familial Mediterranean fever](https:\/\/en.wikipedia.org\/wiki\/Familial_Mediterranean_fever \"Familial Mediterranean fever\"), [adrenal crisis](https:\/\/en.wikipedia.org\/wiki\/Adrenal_crisis \"Adrenal crisis\")\n- Epigastric\n  - Heart: [myocardial infarction](https:\/\/en.wikipedia.org\/wiki\/Myocardial_infarction \"Myocardial infarction\"), [pericarditis](https:\/\/en.wikipedia.org\/wiki\/Pericarditis \"Pericarditis\")\n  - Stomach: [gastritis](https:\/\/en.wikipedia.org\/wiki\/Gastritis \"Gastritis\"), [stomach ulcer](https:\/\/en.wikipedia.org\/wiki\/Stomach_ulcer \"Stomach ulcer\"), [stomach cancer](https:\/\/en.wikipedia.org\/wiki\/Stomach_cancer \"Stomach cancer\")\n  - Pancreas: [pancreatitis](https:\/\/en.wikipedia.org\/wiki\/Pancreatitis \"Pancreatitis\"), [pancreatic cancer](https:\/\/en.wikipedia.org\/wiki\/Pancreatic_cancer \"Pancreatic cancer\")\n  - Intestinal: [duodenal ulcer](https:\/\/en.wikipedia.org\/wiki\/Peptic_ulcer_disease \"Peptic ulcer disease\"), [diverticulitis](https:\/\/en.wikipedia.org\/wiki\/Diverticulitis \"Diverticulitis\"), [appendicitis](https:\/\/en.wikipedia.org\/wiki\/Appendicitis \"Appendicitis\")\n- Right upper quadrant\n  - Liver: [hepatomegaly](https:\/\/en.wikipedia.org\/wiki\/Hepatomegaly \"Hepatomegaly\"), [fatty liver](https:\/\/en.wikipedia.org\/wiki\/Fatty_liver \"Fatty liver\"), [hepatitis](https:\/\/en.wikipedia.org\/wiki\/Hepatitis \"Hepatitis\"), [liver cancer](https:\/\/en.wikipedia.org\/wiki\/Liver_cancer \"Liver cancer\"), [abscess](https:\/\/en.wikipedia.org\/wiki\/Abscess \"Abscess\")\n  - Gallbladder and biliary tract: [inflammation](https:\/\/en.wikipedia.org\/wiki\/Cholecystitis \"Cholecystitis\"), [gallstones](https:\/\/en.wikipedia.org\/wiki\/Gallstone \"Gallstone\"), [worm infection](https:\/\/en.wikipedia.org\/wiki\/Helminthiasis \"Helminthiasis\"), [cholangitis](https:\/\/en.wikipedia.org\/wiki\/Cholangitis \"Cholangitis\")\n  - Colon: [bowel obstruction](https:\/\/en.wikipedia.org\/wiki\/Bowel_obstruction \"Bowel obstruction\"), functional disorders, [gas accumulation](https:\/\/en.wikipedia.org\/wiki\/Bloating \"Bloating\"), [spasm](https:\/\/en.wikipedia.org\/wiki\/Spasm \"Spasm\"), inflammation, [colon cancer](https:\/\/en.wikipedia.org\/wiki\/Colon_cancer \"Colon cancer\")\n  - Other: [pneumonia](https:\/\/en.wikipedia.org\/wiki\/Pneumonia \"Pneumonia\"), [Fitz-Hugh-Curtis syndrome](https:\/\/en.wikipedia.org\/wiki\/Fitz-Hugh%E2%80%93Curtis_syndrome \"Fitz-Hugh–Curtis syndrome\")\n- Left upper quadrant\n  - [Splenomegaly](https:\/\/en.wikipedia.org\/wiki\/Splenomegaly \"Splenomegaly\")\n  - Colon: [bowel obstruction](https:\/\/en.wikipedia.org\/wiki\/Bowel_obstruction \"Bowel obstruction\"), functional disorders, gas accumulation, spasm, inflammation, colon cancer\n- Peri-umbilical (the area around the umbilicus, i.e., the belly button)\n  - [Appendicitis](https:\/\/en.wikipedia.org\/wiki\/Appendicitis \"Appendicitis\")\n  - [Pancreatitis](https:\/\/en.wikipedia.org\/wiki\/Pancreatitis \"Pancreatitis\")\n  - [Inferior myocardial infarction](https:\/\/en.wikipedia.org\/wiki\/Myocardial_infarction \"Myocardial infarction\")\n  - [Peptic ulcer](https:\/\/en.wikipedia.org\/wiki\/Peptic_ulcer_disease \"Peptic ulcer disease\")\n  - [Diabetic ketoacidosis](https:\/\/en.wikipedia.org\/wiki\/Diabetic_ketoacidosis \"Diabetic ketoacidosis\")\n  - Vascular: [aortic dissection](https:\/\/en.wikipedia.org\/wiki\/Aortic_dissection \"Aortic dissection\"), aortic rupture\n  - Bowel: [mesenteric ischemia](https:\/\/en.wikipedia.org\/wiki\/Mesenteric_ischemia \"Mesenteric ischemia\"), [Celiac disease](https:\/\/en.wikipedia.org\/wiki\/Coeliac_disease \"Coeliac disease\"), inflammation, intestinal spasm, functional disorders, [small bowel obstruction](https:\/\/en.wikipedia.org\/wiki\/Bowel_obstruction \"Bowel obstruction\")\n- Lower abdominal pain\n  - [Diarrhea](https:\/\/en.wikipedia.org\/wiki\/Diarrhea \"Diarrhea\")\n  - [Colitis](https:\/\/en.wikipedia.org\/wiki\/Colitis \"Colitis\")\n  - [Crohn's](https:\/\/en.wikipedia.org\/wiki\/Crohn%27s_disease \"Crohn's disease\")\n  - [Dysentery](https:\/\/en.wikipedia.org\/wiki\/Dysentery \"Dysentery\")\n  - [Hernia](https:\/\/en.wikipedia.org\/wiki\/Hernia \"Hernia\")\n- Right lower quadrant\n  - Colon: [intussusception](https:\/\/en.wikipedia.org\/wiki\/Intussusception_\\(medical_disorder\\) \"Intussusception (medical disorder)\"), [bowel obstruction](https:\/\/en.wikipedia.org\/wiki\/Bowel_obstruction \"Bowel obstruction\"), [appendicitis](https:\/\/en.wikipedia.org\/wiki\/Appendicitis \"Appendicitis\") ([McBurney's point](https:\/\/en.wikipedia.org\/wiki\/McBurney%27s_point \"McBurney's point\"))\n  - Renal: [kidney stone](https:\/\/en.wikipedia.org\/wiki\/Kidney_stone_disease \"Kidney stone disease\") (nephrolithiasis), [pyelonephritis](https:\/\/en.wikipedia.org\/wiki\/Pyelonephritis \"Pyelonephritis\")\n  - Pelvic: [cystitis](https:\/\/en.wikipedia.org\/wiki\/Cystitis \"Cystitis\"), [bladder stone](https:\/\/en.wikipedia.org\/wiki\/Bladder_stone \"Bladder stone\"), [bladder cancer](https:\/\/en.wikipedia.org\/wiki\/Bladder_cancer \"Bladder cancer\"), [pelvic inflammatory disease](https:\/\/en.wikipedia.org\/wiki\/Pelvic_inflammatory_disease \"Pelvic inflammatory disease\"), pelvic pain syndrome\n  - Gynecologic: [endometriosis](https:\/\/en.wikipedia.org\/wiki\/Endometriosis \"Endometriosis\"), intrauterine [pregnancy](https:\/\/en.wikipedia.org\/wiki\/Pregnancy \"Pregnancy\"), [ectopic pregnancy](https:\/\/en.wikipedia.org\/wiki\/Ectopic_pregnancy \"Ectopic pregnancy\"), [ovarian cyst](https:\/\/en.wikipedia.org\/wiki\/Ovarian_cyst \"Ovarian cyst\"), [ovarian torsion](https:\/\/en.wikipedia.org\/wiki\/Ovarian_torsion \"Ovarian torsion\"), fibroid ([leiomyoma](https:\/\/en.wikipedia.org\/wiki\/Leiomyoma \"Leiomyoma\")), [abscess](https:\/\/en.wikipedia.org\/wiki\/Abscess \"Abscess\"), [ovarian cancer](https:\/\/en.wikipedia.org\/wiki\/Ovarian_cancer \"Ovarian cancer\"), [endometrial cancer](https:\/\/en.wikipedia.org\/wiki\/Endometrial_cancer \"Endometrial cancer\")\n- Left lower quadrant\n  - Bowel: [diverticulitis](https:\/\/en.wikipedia.org\/wiki\/Diverticulitis \"Diverticulitis\"), [sigmoid colon volvulus](https:\/\/en.wikipedia.org\/wiki\/Sigmoid_colon_volvulus \"Sigmoid colon volvulus\"), [bowel obstruction](https:\/\/en.wikipedia.org\/wiki\/Bowel_obstruction \"Bowel obstruction\"), gas accumulation, [Toxic megacolon](https:\/\/en.wikipedia.org\/wiki\/Toxic_megacolon \"Toxic megacolon\")\n- Right [low back pain](https:\/\/en.wikipedia.org\/wiki\/Low_back_pain \"Low back pain\")\n  - Liver: [hepatomegaly](https:\/\/en.wikipedia.org\/wiki\/Hepatomegaly \"Hepatomegaly\")\n  - Kidney: [kidney stone](https:\/\/en.wikipedia.org\/wiki\/Kidney_stone_disease \"Kidney stone disease\") (nephrolithiasis), complicated urinary tract infection\n- Left low back pain\n  - Spleen\n  - Kidney: [kidney stone](https:\/\/en.wikipedia.org\/wiki\/Kidney_stone_disease \"Kidney stone disease\") (nephrolithiasis), complicated urinary tract infection\n- Low back pain\n  - Kidney pain ([kidney stone](https:\/\/en.wikipedia.org\/wiki\/Kidney_stone \"Kidney stone\"), [kidney cancer](https:\/\/en.wikipedia.org\/wiki\/Kidney_cancer \"Kidney cancer\"), [hydronephrosis](https:\/\/en.wikipedia.org\/wiki\/Hydronephrosis \"Hydronephrosis\"))\n  - [Ureteral stone](https:\/\/en.wikipedia.org\/wiki\/Ureter#Ureteral_stones \"Ureter\") pain\n\n| Region | Blood supply[\\[14\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Moore_2016-14) | Innervation[\\[15\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-15) | Structures[\\[14\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Moore_2016-14) |\n|---|---|---|---|\n| [Foregut](https:\/\/en.wikipedia.org\/wiki\/Foregut \"Foregut\") | [Celiac artery](https:\/\/en.wikipedia.org\/wiki\/Celiac_artery \"Celiac artery\") | T5 - T9 | [Pharynx](https:\/\/en.wikipedia.org\/wiki\/Pharynx \"Pharynx\") [Esophagus](https:\/\/en.wikipedia.org\/wiki\/Esophagus \"Esophagus\")[Lower respiratory tract](https:\/\/en.wikipedia.org\/wiki\/Respiratory_tract \"Respiratory tract\")[Stomach](https:\/\/en.wikipedia.org\/wiki\/Stomach \"Stomach\")Proximal [duodenum](https:\/\/en.wikipedia.org\/wiki\/Duodenum \"Duodenum\")[Liver](https:\/\/en.wikipedia.org\/wiki\/Liver \"Liver\")[Biliary tract](https:\/\/en.wikipedia.org\/wiki\/Biliary_tract \"Biliary tract\")[Gallbladder](https:\/\/en.wikipedia.org\/wiki\/Gallbladder \"Gallbladder\")[Pancreas](https:\/\/en.wikipedia.org\/wiki\/Pancreas \"Pancreas\") |\n| [Midgut](https:\/\/en.wikipedia.org\/wiki\/Midgut \"Midgut\") | [Superior mesenteric artery](https:\/\/en.wikipedia.org\/wiki\/Superior_mesenteric_artery \"Superior mesenteric artery\") | T10 – T12 | Distal [duodenum](https:\/\/en.wikipedia.org\/wiki\/Duodenum \"Duodenum\") [Cecum](https:\/\/en.wikipedia.org\/wiki\/Cecum \"Cecum\")[Appendix](https:\/\/en.wikipedia.org\/wiki\/Appendix_\\(anatomy\\) \"Appendix (anatomy)\")[Ascending colon](https:\/\/en.wikipedia.org\/wiki\/Ascending_colon \"Ascending colon\")Proximal [transverse colon](https:\/\/en.wikipedia.org\/wiki\/Transverse_colon \"Transverse colon\") |\n| [Hindgut](https:\/\/en.wikipedia.org\/wiki\/Hindgut \"Hindgut\") | [Inferior mesenteric artery](https:\/\/en.wikipedia.org\/wiki\/Inferior_mesenteric_artery \"Inferior mesenteric artery\") | L1 – L3 | Distal [transverse colon](https:\/\/en.wikipedia.org\/wiki\/Transverse_colon \"Transverse colon\") [Descending colon](https:\/\/en.wikipedia.org\/wiki\/Descending_colon \"Descending colon\")[Sigmoid colon](https:\/\/en.wikipedia.org\/wiki\/Sigmoid_colon \"Sigmoid colon\")[Rectum](https:\/\/en.wikipedia.org\/wiki\/Rectum \"Rectum\")Superior [anal canal](https:\/\/en.wikipedia.org\/wiki\/Anal_canal \"Anal canal\") |\n\nAbdominal pain can be referred to as [visceral pain](https:\/\/en.wikipedia.org\/wiki\/Visceral_pain \"Visceral pain\") or [peritoneal](https:\/\/en.wikipedia.org\/wiki\/Peritoneum \"Peritoneum\") pain. The contents of the abdomen can be divided into the [foregut](https:\/\/en.wikipedia.org\/wiki\/Foregut \"Foregut\"), [midgut](https:\/\/en.wikipedia.org\/wiki\/Midgut \"Midgut\"), and [hindgut](https:\/\/en.wikipedia.org\/wiki\/Hindgut \"Hindgut\").[\\[14\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Moore_2016-14) The [foregut](https:\/\/en.wikipedia.org\/wiki\/Foregut \"Foregut\") contains the [pharynx](https:\/\/en.wikipedia.org\/wiki\/Pharynx \"Pharynx\"), lower [respiratory tract](https:\/\/en.wikipedia.org\/wiki\/Respiratory_tract \"Respiratory tract\"), portions of the [esophagus](https:\/\/en.wikipedia.org\/wiki\/Esophagus \"Esophagus\"), [stomach](https:\/\/en.wikipedia.org\/wiki\/Stomach \"Stomach\"), portions of the [duodenum](https:\/\/en.wikipedia.org\/wiki\/Duodenum \"Duodenum\") (proximal), [liver](https:\/\/en.wikipedia.org\/wiki\/Liver \"Liver\"), [biliary tract](https:\/\/en.wikipedia.org\/wiki\/Biliary_tract \"Biliary tract\") (including the [gallbladder](https:\/\/en.wikipedia.org\/wiki\/Gallbladder \"Gallbladder\") and [bile ducts](https:\/\/en.wikipedia.org\/wiki\/Bile_duct \"Bile duct\")), and the [pancreas](https:\/\/en.wikipedia.org\/wiki\/Pancreas \"Pancreas\").[\\[14\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Moore_2016-14) The midgut contains portions of the [duodenum](https:\/\/en.wikipedia.org\/wiki\/Duodenum \"Duodenum\") (distal), [cecum](https:\/\/en.wikipedia.org\/wiki\/Cecum \"Cecum\"), [appendix](https:\/\/en.wikipedia.org\/wiki\/Appendix_\\(anatomy\\) \"Appendix (anatomy)\"), [ascending colon](https:\/\/en.wikipedia.org\/wiki\/Ascending_colon \"Ascending colon\"), and first half of the [transverse colon](https:\/\/en.wikipedia.org\/wiki\/Transverse_colon \"Transverse colon\").[\\[14\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Moore_2016-14) The hindgut contains the distal half of the transverse colon, [descending colon](https:\/\/en.wikipedia.org\/wiki\/Descending_colon \"Descending colon\"), [sigmoid colon](https:\/\/en.wikipedia.org\/wiki\/Sigmoid_colon \"Sigmoid colon\"), [rectum](https:\/\/en.wikipedia.org\/wiki\/Rectum \"Rectum\"), and superior [anal canal](https:\/\/en.wikipedia.org\/wiki\/Anal_canal \"Anal canal\").[\\[14\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Moore_2016-14)\n\nEach subsection of the gut has an associated visceral afferent nerve that transmits sensory information from the viscera to the spinal cord.[\\[16\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-16) The visceral sensory information from the gut traveling to the spinal cord, termed the visceral afferent, is non-specific and overlaps with the somatic afferent nerves, which are very specific.[\\[17\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Neumayer_2013-17) Therefore, visceral afferent information traveling to the spinal cord can present in the distribution of the somatic afferent nerve; this is why [appendicitis](https:\/\/en.wikipedia.org\/wiki\/Appendicitis \"Appendicitis\") initially presents with T10 periumbilical pain when it first begins and becomes T12 pain as the abdominal wall peritoneum (which is rich with somatic afferent nerves) is involved.[\\[17\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Neumayer_2013-17)\n\nA thorough patient history and physical examination is used to better understand the underlying cause of abdominal pain.\n\nThe process of gathering a history may include:[\\[18\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Bickley_2016-18)\n\n- Identifying more information about the [chief complaint](https:\/\/en.wikipedia.org\/wiki\/Presenting_problem \"Presenting problem\") by eliciting a [history of present illness](https:\/\/en.wikipedia.org\/wiki\/History_of_the_present_illness \"History of the present illness\"); i.e. a narrative of the current symptoms such as the onset, location, duration, character, aggravating or relieving factors, and temporal nature of the pain. Identifying other possible factors may aid in the diagnosis of the underlying cause of abdominal pain, such as recent travel, recent contact with other ill individuals, and for females, a thorough [gynecologic](https:\/\/en.wikipedia.org\/wiki\/Gynaecology \"Gynaecology\") history.\n- Learning about the patient's past medical history, focusing on any prior issues or surgical procedures.\n- Clarifying the patient's current medication regimen, including prescriptions, over-the-counter medications, and supplements.\n- Confirming the patient's drug and food allergies.\n- Discussing with the patient any family history of disease processes, focusing on conditions that might resemble the patient's current presentation.\n- Discussing with the patient any health-related behaviors (e.g. tobacco use, alcohol consumption, drug use, and sexual activity) that might make certain diagnoses more likely.\n- Reviewing the presence of non-abdominal symptoms (e.g., [fever](https:\/\/en.wikipedia.org\/wiki\/Fever \"Fever\"), chills, [chest pain](https:\/\/en.wikipedia.org\/wiki\/Chest_pain \"Chest pain\"), [shortness of breath](https:\/\/en.wikipedia.org\/wiki\/Shortness_of_breath \"Shortness of breath\"), [vaginal bleeding](https:\/\/en.wikipedia.org\/wiki\/Vaginal_bleeding \"Vaginal bleeding\")) that can further clarify the diagnostic picture.\n- Using [Carnett's sign](https:\/\/en.wikipedia.org\/wiki\/Carnett%27s_sign \"Carnett's sign\") to differentiate between [visceral pain](https:\/\/en.wikipedia.org\/wiki\/Visceral_pain \"Visceral pain\") and pain originating in the muscles of the abdominal wall.[\\[19\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-19)\n\nAfter gathering a thorough history, one should perform a [physical exam](https:\/\/en.wikipedia.org\/wiki\/Physical_examination \"Physical examination\") in order to identify important physical signs that might clarify the diagnosis, including a [cardiovascular exam](https:\/\/en.wikipedia.org\/wiki\/Cardiovascular_examination \"Cardiovascular examination\"), lung exam, thorough abdominal exam, and for females, a [genitourinary](https:\/\/en.wikipedia.org\/wiki\/Genitourinary_system \"Genitourinary system\") exam.[\\[18\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Bickley_2016-18)\n\nAdditional investigations that can aid diagnosis include:[\\[20\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Cartwright_2008-20)\n\n- Blood tests including [complete blood count](https:\/\/en.wikipedia.org\/wiki\/Complete_blood_count \"Complete blood count\"), [basic metabolic panel](https:\/\/en.wikipedia.org\/wiki\/Basic_metabolic_panel \"Basic metabolic panel\"), [electrolytes](https:\/\/en.wikipedia.org\/wiki\/Electrolyte \"Electrolyte\"), [liver function tests](https:\/\/en.wikipedia.org\/wiki\/Liver_function_tests \"Liver function tests\"), [amylase](https:\/\/en.wikipedia.org\/wiki\/Amylase \"Amylase\"), [lipase](https:\/\/en.wikipedia.org\/wiki\/Lipase \"Lipase\"), [troponin I](https:\/\/en.wikipedia.org\/wiki\/Troponin_I \"Troponin I\"), and for females, a serum [pregnancy test](https:\/\/en.wikipedia.org\/wiki\/Pregnancy_test \"Pregnancy test\").\n- [Urinalysis](https:\/\/en.wikipedia.org\/wiki\/Urinalysis \"Urinalysis\")\n- Imaging including chest and abdominal [X-rays](https:\/\/en.wikipedia.org\/wiki\/X-ray \"X-ray\")\n- [Electrocardiogram](https:\/\/en.wikipedia.org\/wiki\/Electrocardiograph \"Electrocardiograph\")\n\nIf diagnosis remains unclear after history, examination, and basic investigations as above, then more advanced investigations may reveal a diagnosis. Such tests include:[\\[20\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Cartwright_2008-20)\n\n- [Computed tomography](https:\/\/en.wikipedia.org\/wiki\/Computed_tomography \"Computed tomography\") of the abdomen\/pelvis\n- Abdominal or pelvic [ultrasound](https:\/\/en.wikipedia.org\/wiki\/Ultrasound \"Ultrasound\")\n- [Endoscopy](https:\/\/en.wikipedia.org\/wiki\/Endoscopy \"Endoscopy\") or [colonoscopy](https:\/\/en.wikipedia.org\/wiki\/Colonoscopy \"Colonoscopy\")\n\nThe management of abdominal pain depends on many factors, including the etiology of the pain. Some behavioural changes implemented to prevent pain include: resting after a meal, chewing food completely and slowly, and avoiding stressful and high excitement situations after a meal. Such at home strategies may reduce the need to seek professional assistance via prevention of future abdominal pain.[\\[21\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-21) In the emergency department, a person presenting with abdominal pain may initially require IV fluids due to decreased intake secondary to abdominal pain and possible emesis or vomiting.[\\[22\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Mahadevan-22) Treatment for abdominal pain includes analgesia, such as non-opioid (ketorolac) and opioid medications ([morphine](https:\/\/en.wikipedia.org\/wiki\/Morphine \"Morphine\"), [fentanyl](https:\/\/en.wikipedia.org\/wiki\/Fentanyl \"Fentanyl\")).[\\[22\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Mahadevan-22) Choice of [analgesia](https:\/\/en.wikipedia.org\/wiki\/Analgesia \"Analgesia\") is dependent on the cause of the pain, as [ketorolac](https:\/\/en.wikipedia.org\/wiki\/Ketorolac \"Ketorolac\") can worsen some intra-abdominal processes.[\\[22\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Mahadevan-22) Patients presenting to the emergency department with abdominal pain may receive a \"GI cocktail\" that includes an [antacid](https:\/\/en.wikipedia.org\/wiki\/Antacid \"Antacid\") (examples include [omeprazole](https:\/\/en.wikipedia.org\/wiki\/Omeprazole \"Omeprazole\"), [famotidine](https:\/\/en.wikipedia.org\/wiki\/Famotidine \"Famotidine\"), [magnesium hydroxide](https:\/\/en.wikipedia.org\/wiki\/Magnesium_hydroxide \"Magnesium hydroxide\"), and [calcium carbonate](https:\/\/en.wikipedia.org\/wiki\/Calcium_carbonate \"Calcium carbonate\")) and [lidocaine](https:\/\/en.wikipedia.org\/wiki\/Lidocaine \"Lidocaine\").[\\[22\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Mahadevan-22) After addressing pain, there may be a role for [antimicrobial](https:\/\/en.wikipedia.org\/wiki\/Antimicrobial \"Antimicrobial\") treatment in some cases of abdominal pain.[\\[22\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Mahadevan-22) [Butylscopolamine](https:\/\/en.wikipedia.org\/wiki\/Butylscopolamine \"Butylscopolamine\") (Buscopan) is used to treat cramping abdominal pain with some success.[\\[23\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-23) Surgical management for causes of abdominal pain includes but is not limited to [cholecystectomy](https:\/\/en.wikipedia.org\/wiki\/Cholecystectomy \"Cholecystectomy\"), [appendectomy](https:\/\/en.wikipedia.org\/wiki\/Appendectomy \"Appendectomy\"), and exploratory [laparotomy](https:\/\/en.wikipedia.org\/wiki\/Laparotomy \"Laparotomy\").\\[*[citation needed](https:\/\/en.wikipedia.org\/wiki\/Wikipedia:Citation_needed \"Wikipedia:Citation needed\")*\\]\n\nBelow is a brief overview of abdominal pain emergencies.\n\n| Condition | Presentation | Diagnosis | Management |\n|---|---|---|---|\n| [Appendicitis](https:\/\/en.wikipedia.org\/wiki\/Appendicitis \"Appendicitis\")[\\[24\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Sherman_2016-24) | Abdominal pain, nausea, vomiting, fever Periumbilical pain, migrates to RLQ | Clinical (history and physical exam) Abdominal CT | Patient made NPO (nothing by mouth) IV fluids as neededGeneral surgery consultation, possible [appendectomy](https:\/\/en.wikipedia.org\/wiki\/Appendectomy \"Appendectomy\")AntibioticsPain control |\n| [Cholecystitis](https:\/\/en.wikipedia.org\/wiki\/Cholecystitis \"Cholecystitis\")[\\[24\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Sherman_2016-24) | Abdominal pain (RUQ, radiates epigastric), nausea, vomiting, fever, [Murphy's sign](https:\/\/en.wikipedia.org\/wiki\/Murphy%27s_sign \"Murphy's sign\") | Clinical (history and physical exam) Imaging (RUQ ultrasound)Labs ([leukocytosis](https:\/\/en.wikipedia.org\/wiki\/Leukocytosis \"Leukocytosis\"), [transamintis](https:\/\/en.wikipedia.org\/wiki\/Elevated_transaminases \"Elevated transaminases\"), [hyperbilirubinemia](https:\/\/en.wikipedia.org\/wiki\/Hyperbilirubinemia \"Hyperbilirubinemia\")) | Patient made NPO (nothing by mouth) IV fluids as neededGeneral surgery consultation, possible [cholecystectomy](https:\/\/en.wikipedia.org\/wiki\/Cholecystectomy \"Cholecystectomy\")AntibioticsPain, nausea control |\n| [Acute pancreatitis](https:\/\/en.wikipedia.org\/wiki\/Acute_pancreatitis \"Acute pancreatitis\")[\\[24\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Sherman_2016-24) | Abdominal pain (sharp epigastric, shooting to back), nausea, vomiting | Clinical (history and physical exam) Labs (elevated [lipase](https:\/\/en.wikipedia.org\/wiki\/Lipase \"Lipase\"))Imaging (abdominal CT, ultrasound) | Patient made NPO (nothing by mouth) IV fluids as neededPain, nausea controlPossibly consultation of [general surgery](https:\/\/en.wikipedia.org\/wiki\/Surgery \"Surgery\") or [interventional radiology](https:\/\/en.wikipedia.org\/wiki\/Interventional_radiology \"Interventional radiology\") |\n| [Bowel obstruction](https:\/\/en.wikipedia.org\/wiki\/Bowel_obstruction \"Bowel obstruction\")[\\[24\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Sherman_2016-24) | Abdominal pain (diffuse, crampy), [bilious](https:\/\/en.wikipedia.org\/wiki\/Bile \"Bile\") [emesis](https:\/\/en.wikipedia.org\/wiki\/Vomiting \"Vomiting\"), [constipation](https:\/\/en.wikipedia.org\/wiki\/Constipation \"Constipation\") | Clinical (history and physical exam) Imaging (abdominal X-ray, abdominal CT) | Patient made NPO (nothing by mouth) IV fluids as needed[Nasogastric tube](https:\/\/en.wikipedia.org\/wiki\/Nasogastric_intubation \"Nasogastric intubation\") placement[General surgery](https:\/\/en.wikipedia.org\/wiki\/General_surgery \"General surgery\") consultationPain control |\n| [Upper GI bleed](https:\/\/en.wikipedia.org\/wiki\/Upper_gastrointestinal_bleeding \"Upper gastrointestinal bleeding\")[\\[24\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Sherman_2016-24) | Abdominal pain (epigastric), [hematochezia](https:\/\/en.wikipedia.org\/wiki\/Hematochezia \"Hematochezia\"), [melena](https:\/\/en.wikipedia.org\/wiki\/Melena \"Melena\"), [hematemesis](https:\/\/en.wikipedia.org\/wiki\/Hematemesis \"Hematemesis\"), [hypovolemia](https:\/\/en.wikipedia.org\/wiki\/Hypovolemia \"Hypovolemia\") | Clinical (history & physical exam, including [digital rectal exam](https:\/\/en.wikipedia.org\/wiki\/Rectal_examination \"Rectal examination\")) Labs ([complete blood count](https:\/\/en.wikipedia.org\/wiki\/Complete_blood_count \"Complete blood count\"), coagulation profile, [transaminases](https:\/\/en.wikipedia.org\/wiki\/Transaminase \"Transaminase\"), [stool guaiac](https:\/\/en.wikipedia.org\/wiki\/Stool_guaiac_test \"Stool guaiac test\")) | Aggressive IV fluid resuscitation [Blood transfusion](https:\/\/en.wikipedia.org\/wiki\/Blood_transfusion \"Blood transfusion\") as neededMedications: [proton pump inhibitor](https:\/\/en.wikipedia.org\/wiki\/Proton-pump_inhibitor \"Proton-pump inhibitor\"), [octreotide](https:\/\/en.wikipedia.org\/wiki\/Octreotide \"Octreotide\")Stable patient: observationUnstable patient: consultation ([general surgery](https:\/\/en.wikipedia.org\/wiki\/General_surgery \"General surgery\"), [gastroenterology](https:\/\/en.wikipedia.org\/wiki\/Gastroenterology \"Gastroenterology\"), [interventional radiology](https:\/\/en.wikipedia.org\/wiki\/Interventional_radiology \"Interventional radiology\")) |\n| Lower [GI bleed](https:\/\/en.wikipedia.org\/wiki\/Gastrointestinal_bleeding \"Gastrointestinal bleeding\")[\\[24\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Sherman_2016-24) | Abdominal pain, [hematochezia](https:\/\/en.wikipedia.org\/wiki\/Hematochezia \"Hematochezia\"), [melena](https:\/\/en.wikipedia.org\/wiki\/Melena \"Melena\"), [hypovolemia](https:\/\/en.wikipedia.org\/wiki\/Hypovolemia \"Hypovolemia\") | Clinical (history and physical exam, including [digital rectal exam](https:\/\/en.wikipedia.org\/wiki\/Rectal_examination \"Rectal examination\")) Labs ([complete blood count](https:\/\/en.wikipedia.org\/wiki\/Complete_blood_count \"Complete blood count\"), coagulation profile, [transaminases](https:\/\/en.wikipedia.org\/wiki\/Transaminase \"Transaminase\"), [stool guaiac](https:\/\/en.wikipedia.org\/wiki\/Stool_guaiac_test \"Stool guaiac test\")) | Aggressive IV fluid resuscitation [Blood transfusion](https:\/\/en.wikipedia.org\/wiki\/Blood_transfusion \"Blood transfusion\") as neededMedications: [proton pump inhibitor](https:\/\/en.wikipedia.org\/wiki\/Proton-pump_inhibitor \"Proton-pump inhibitor\")Stable patient: observationUnstable patient: consultation ([general surgery](https:\/\/en.wikipedia.org\/wiki\/General_surgery \"General surgery\"), [gastroenterology](https:\/\/en.wikipedia.org\/wiki\/Gastroenterology \"Gastroenterology\"), [interventional radiology](https:\/\/en.wikipedia.org\/wiki\/Interventional_radiology \"Interventional radiology\")) |\n| Perforated Viscous[\\[24\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Sherman_2016-24) | Abdominal pain (sudden onset of localized pain), [abdominal distension](https:\/\/en.wikipedia.org\/wiki\/Abdominal_distension \"Abdominal distension\"), rigid abdomen | Clinical (history and physical exam) Imaging (abdominal X-ray or CT showing free air)Labs ([complete blood count](https:\/\/en.wikipedia.org\/wiki\/Complete_blood_count \"Complete blood count\")) | Aggressive IV fluid resuscitation [General surgery](https:\/\/en.wikipedia.org\/wiki\/General_surgery \"General surgery\") consultationAntibiotics |\n| [Volvulus](https:\/\/en.wikipedia.org\/wiki\/Volvulus \"Volvulus\")[\\[24\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Sherman_2016-24) | [Sigmoid colon volvulus](https:\/\/en.wikipedia.org\/wiki\/Sigmoid_colon_volvulus \"Sigmoid colon volvulus\"): Abdominal pain (\\>2 days, distention, constipation) Cecal volvulus: Abdominal pain (acute onset), nausea, vomiting | Clinical (history and physical exam) Imaging (abdominal X-ray or CT) | Sigmoid: [Gastroenterology](https:\/\/en.wikipedia.org\/wiki\/Gastroenterology \"Gastroenterology\") consultation ([flexibile sigmoidoscopy](https:\/\/en.wikipedia.org\/wiki\/Sigmoidoscopy \"Sigmoidoscopy\")) Cecal: [General surgery](https:\/\/en.wikipedia.org\/wiki\/General_surgery \"General surgery\") consultation ([right hemicolectomy](https:\/\/en.wikipedia.org\/wiki\/Colectomy \"Colectomy\")) |\n| [Ectopic pregnancy](https:\/\/en.wikipedia.org\/wiki\/Ectopic_pregnancy \"Ectopic pregnancy\")[\\[24\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Sherman_2016-24) | Abdominal and pelvic pain, bleeding If ruptured ectopic pregnancy, the patient may present with peritoneal irritation and [hypovolemic shock](https:\/\/en.wikipedia.org\/wiki\/Hypovolemic_shock \"Hypovolemic shock\") | Clinical (history and physical exam) Labs: [complete blood count](https:\/\/en.wikipedia.org\/wiki\/Complete_blood_count \"Complete blood count\"), urine pregnancy test followed with quantitative blood [beta-hCG](https:\/\/en.wikipedia.org\/wiki\/Human_chorionic_gonadotropin \"Human chorionic gonadotropin\")Imaging: [transvaginal ultrasound](https:\/\/en.wikipedia.org\/wiki\/Vaginal_ultrasonography \"Vaginal ultrasonography\") | If patient is unstable: IV fluid resuscitation, urgent [obstetrics and gynecology](https:\/\/en.wikipedia.org\/wiki\/Obstetrics_and_gynaecology \"Obstetrics and gynaecology\") consultation If patient is stable: continue diagnostic workup, establish [OBGYN](https:\/\/en.wikipedia.org\/wiki\/Obstetrics_and_gynaecology \"Obstetrics and gynaecology\") follow-up |\n| [Abdominal aortic aneurysm](https:\/\/en.wikipedia.org\/wiki\/Abdominal_aortic_aneurysm \"Abdominal aortic aneurysm\")[\\[24\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Sherman_2016-24) | Abdominal pain, flank pain, back pain, hypotension, pulsatile abdominal mass | Clinical (history and physical exam) Imaging: Ultrasound, [CT angiography](https:\/\/en.wikipedia.org\/wiki\/Computed_tomography_angiography \"Computed tomography angiography\"), MRA\/[magnetic resonance angiography](https:\/\/en.wikipedia.org\/wiki\/Magnetic_resonance_angiography \"Magnetic resonance angiography\") | If patient is unstable: IV fluid resuscitation, urgent surgical consultation If patient is stable: admit for observation |\n| [Aortic dissection](https:\/\/en.wikipedia.org\/wiki\/Aortic_dissection \"Aortic dissection\")[\\[24\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Sherman_2016-24) | Abdominal pain (sudden onset of epigastric or back pain), hypertension, new aortic [murmur](https:\/\/en.wikipedia.org\/wiki\/Heart_murmur \"Heart murmur\") | Clinical (history and physical exam) Imaging: Chest X-ray (showing widened [mediastinum](https:\/\/en.wikipedia.org\/wiki\/Mediastinum \"Mediastinum\")), [CT angiography](https:\/\/en.wikipedia.org\/wiki\/Computed_tomography_angiography \"Computed tomography angiography\"), [MRA](https:\/\/en.wikipedia.org\/wiki\/Magnetic_resonance_angiography \"Magnetic resonance angiography\"), [transthoracic echocardiogram](https:\/\/en.wikipedia.org\/wiki\/Transthoracic_echocardiogram \"Transthoracic echocardiogram\")\/TTE, [transesophageal echocardiogram](https:\/\/en.wikipedia.org\/wiki\/Transesophageal_echocardiogram \"Transesophageal echocardiogram\")\/TEE | IV fluid resuscitation [Blood transfusion](https:\/\/en.wikipedia.org\/wiki\/Blood_transfusion \"Blood transfusion\") as needed (obtain [type and cross](https:\/\/en.wikipedia.org\/wiki\/Blood_transfusion \"Blood transfusion\"))Medications: reduce blood pressure ([sodium nitroprusside](https:\/\/en.wikipedia.org\/wiki\/Sodium_nitroprusside \"Sodium nitroprusside\") plus [beta blocker](https:\/\/en.wikipedia.org\/wiki\/Beta_blocker \"Beta blocker\") or [calcium channel blocker](https:\/\/en.wikipedia.org\/wiki\/Calcium_channel_blocker \"Calcium channel blocker\"))Surgery consultation |\n| [Liver injury](https:\/\/en.wikipedia.org\/wiki\/Liver_injury \"Liver injury\")[\\[24\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Sherman_2016-24) | After trauma ([blunt](https:\/\/en.wikipedia.org\/wiki\/Blunt_trauma \"Blunt trauma\") or [penetrating](https:\/\/en.wikipedia.org\/wiki\/Penetrating_trauma \"Penetrating trauma\")), abdominal pain (RUQ), right rib pain, right flank pain, right shoulder pain | Clinical (history and physical exam) Imaging: [FAST](https:\/\/en.wikipedia.org\/wiki\/Focused_assessment_with_sonography_for_trauma \"Focused assessment with sonography for trauma\") examination, CT of abdomen and pelvis[Diagnostic peritoneal aspiration and lavage](https:\/\/en.wikipedia.org\/wiki\/Diagnostic_peritoneal_lavage \"Diagnostic peritoneal lavage\") | Resuscitation ([advanced trauma life support](https:\/\/en.wikipedia.org\/wiki\/Advanced_trauma_life_support \"Advanced trauma life support\")) with IV fluids ([crystalloid](https:\/\/en.wikipedia.org\/wiki\/Fluid_replacement \"Fluid replacement\")) and [blood transfusion](https:\/\/en.wikipedia.org\/wiki\/Blood_transfusion \"Blood transfusion\") If patient is unstable: [general](https:\/\/en.wikipedia.org\/wiki\/General_surgery \"General surgery\") or [trauma surgery](https:\/\/en.wikipedia.org\/wiki\/Trauma_surgery \"Trauma surgery\") consultation with subsequent [exploratory laparotomy](https:\/\/en.wikipedia.org\/wiki\/Exploratory_laparotomy \"Exploratory laparotomy\") |\n| [Splenic injury](https:\/\/en.wikipedia.org\/wiki\/Splenic_injury \"Splenic injury\")[\\[24\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Sherman_2016-24) | After trauma ([blunt](https:\/\/en.wikipedia.org\/wiki\/Blunt_trauma \"Blunt trauma\") or [penetrating](https:\/\/en.wikipedia.org\/wiki\/Penetrating_trauma \"Penetrating trauma\")), abdominal pain (LUQ), left rib pain, left flank pain | Clinical (history and physical exam) Imaging: [FAST](https:\/\/en.wikipedia.org\/wiki\/Focused_assessment_with_sonography_for_trauma \"Focused assessment with sonography for trauma\") examination, CT of abdomen and pelvis[Diagnostic peritoneal aspiration and lavage](https:\/\/en.wikipedia.org\/wiki\/Diagnostic_peritoneal_lavage \"Diagnostic peritoneal lavage\") | Resuscitation ([advanced trauma life support](https:\/\/en.wikipedia.org\/wiki\/Advanced_trauma_life_support \"Advanced trauma life support\")) with IV fluids ([crystalloid](https:\/\/en.wikipedia.org\/wiki\/Fluid_replacement \"Fluid replacement\")) and [blood transfusion](https:\/\/en.wikipedia.org\/wiki\/Blood_transfusion \"Blood transfusion\") If patient is unstable: [general](https:\/\/en.wikipedia.org\/wiki\/General_surgery \"General surgery\") or [trauma surgery](https:\/\/en.wikipedia.org\/wiki\/Trauma_surgery \"Trauma surgery\") consultation with subsequent [exploratory laparotomy](https:\/\/en.wikipedia.org\/wiki\/Exploratory_laparotomy \"Exploratory laparotomy\") and possible [splenectomy](https:\/\/en.wikipedia.org\/wiki\/Splenectomy \"Splenectomy\")If patient is stable: medical management, consultation of [interventional radiology](https:\/\/en.wikipedia.org\/wiki\/Interventional_radiology \"Interventional radiology\") for possible [arterial embolization](https:\/\/en.wikipedia.org\/wiki\/Embolization \"Embolization\") |\n\nOne well-known aspect of primary health care is its low prevalence of potentially dangerous abdominal pain causes. Patients with abdominal pain have a higher percentage of unexplained complaints (category \"no diagnosis\") than patients with other symptoms (such as [dyspnea](https:\/\/en.wikipedia.org\/wiki\/Dyspnea \"Dyspnea\") or [chest pain](https:\/\/en.wikipedia.org\/wiki\/Chest_pain \"Chest pain\")).[\\[25\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-A_C_T_R_p.-25) Most people who suffer from stomach pain have a benign issue, like [dyspepsia](https:\/\/en.wikipedia.org\/wiki\/Indigestion \"Indigestion\").[\\[26\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Gulacti_Arslan_Ooi_Tuck_2001_pp._123%E2%80%93136-26) In general, it is discovered that 20% to 25% of patients with abdominal pain have a serious condition that necessitates admission to an acute care hospital.[\\[27\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Chandramohan_Pari_Schrock_Lum_1991_pp._503%E2%80%93507-27)\n\nAbdominal pain is the reason about 3% of adults see their family physician.[\\[2\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Vin2014-2) Rates of [emergency department](https:\/\/en.wikipedia.org\/wiki\/Emergency_department \"Emergency department\") (ED) visits in the United States for abdominal pain increased 18% from 2006 through to 2011. This was the largest increase out of 20 common conditions seen in the ED. The rate of ED use for nausea and vomiting also increased 18%.[\\[28\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-28)\n\n## Special populations\n\\[[edit](https:\/\/en.wikipedia.org\/w\/index.php?title=Abdominal_pain&action=edit&section=19 \"Edit section: Special populations\")\\]\n\nMore time and resources are used on older patients with abdominal pain than on any other patient presentation in the emergency department (ED).[\\[29\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-SA_LZ_p.-29) Compared to younger patients with the same complaint, their length of stay is 20% longer, they need to be admitted almost half the time, and they need surgery 1\/3 of the time.[\\[30\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Rodr%C3%ADguez-Lomba_Pulido-P%C3%A9rez_Ricciardi_Marcello_1976_pp._219%E2%80%93223-30)\n\nAge does not reduce the total number of [T cells](https:\/\/en.wikipedia.org\/wiki\/T_cell \"T cell\"), but it does reduce their functionality. The elderly person's ability to fight infection is weakened as a result.[\\[31\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Weyand_Goronzy_p.-31) Additionally, they have changed the strength and integrity of their skin and [mucous membranes](https:\/\/en.wikipedia.org\/wiki\/Mucous_membrane \"Mucous membrane\"), which are physical barriers to infection. It is well known that older patients experience altered pain perception.[\\[32\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Sherman_p.-32)\n\nThe challenge of obtaining a sufficient history from an elderly patient can be attributed to multiple factors. Reduced memory or hearing could make the issue worse. It is common to encounter stoicism combined with a fear of losing one's independence if a serious condition is discovered. Changes in mental status, whether acute or chronic, are common.[\\[33\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Isani_Kim_Mateu_Tormo_2006_pp._371%E2%80%93388-33)\n\nUnique clinical challenges arise when pregnant women experience abdominal pain. First off, there are many possible causes of abdominal pain during pregnancy. These include intraabdominal diseases that arise incidentally during pregnancy as well as obstetric or gynecologic disorders associated with pregnancy. Secondly, pregnancy modifies the natural history and clinical manifestation of numerous abdominal disorders.[\\[34\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-34) Third, pregnancy modifies and limits the diagnostic assessment. For instance, concerns about fetal safety during pregnancy are raised by invasive exams and radiologic testing. Fourth, while receiving therapy during pregnancy, the mother's and the fetus' interests need to be taken into account.[\\[35\\]](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_note-Souza_Ferreira_Young_Cerit_2003_pp._1%E2%80%9358-35)\n\n- [Abdominal distension](https:\/\/en.wikipedia.org\/wiki\/Abdominal_distension \"Abdominal distension\")\n- [Abdominal mass](https:\/\/en.wikipedia.org\/wiki\/Abdominal_mass \"Abdominal mass\")\n\n1. **[^](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-Stat2018_1-0)**\n   Patterson JW, Dominique E (14 November 2018). \"Acute Abdomenal\". *StatPearls*. [PMID](https:\/\/en.wikipedia.org\/wiki\/PMID_\\(identifier\\) \"PMID (identifier)\") [29083722](https:\/\/pubmed.ncbi.nlm.nih.gov\/29083722).\n2. ^ [***a***](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-Vin2014_2-0) [***b***](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-Vin2014_2-1) [***c***](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-Vin2014_2-2) [***d***](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-Vin2014_2-3) [***e***](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-Vin2014_2-4)\n   Viniol A, Keunecke C, Biroga T, Stadje R, Dornieden K, Bösner S, et al. (October 2014). [\"Studies of the symptom abdominal pain—a systematic review and meta-analysis\"](https:\/\/doi.org\/10.1093%2Ffampra%2Fcmu036). *Family Practice*. **31** (5): 517–29\\. [doi](https:\/\/en.wikipedia.org\/wiki\/Doi_\\(identifier\\) \"Doi (identifier)\"):[10\\.1093\/fampra\/cmu036](https:\/\/doi.org\/10.1093%2Ffampra%2Fcmu036). [PMID](https:\/\/en.wikipedia.org\/wiki\/PMID_\\(identifier\\) \"PMID (identifier)\") [24987023](https:\/\/pubmed.ncbi.nlm.nih.gov\/24987023).\n3. ^ [***a***](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-Hopcroft2020_3-0) [***b***](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-Hopcroft2020_3-1)\n   Hopcroft K, Forte V (2020). [\"Abdomen\"](https:\/\/books.google.com\/books?id=pr_gDwAAQBAJ&pg=PA9). *Symptom Sorter* (6th ed.). Boca Raton: CRC Press. pp. 9–17\\. [ISBN](https:\/\/en.wikipedia.org\/wiki\/ISBN_\\(identifier\\) \"ISBN (identifier)\")\n   \n   [9780367468101](https:\/\/en.wikipedia.org\/wiki\/Special:BookSources\/9780367468101 \"Special:BookSources\/9780367468101\")\n   \n   .\n4. ^ [***a***](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-Sherman_1990_r770_4-0) [***b***](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-Sherman_1990_r770_4-1)\n   Sherman R (1990). [*Abdominal Pain*](https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK412\/). Butterworths. [ISBN](https:\/\/en.wikipedia.org\/wiki\/ISBN_\\(identifier\\) \"ISBN (identifier)\")\n   \n   [978-0-409-90077-4](https:\/\/en.wikipedia.org\/wiki\/Special:BookSources\/978-0-409-90077-4 \"Special:BookSources\/978-0-409-90077-4\")\n   \n   . [PMID](https:\/\/en.wikipedia.org\/wiki\/PMID_\\(identifier\\) \"PMID (identifier)\") [21250252](https:\/\/pubmed.ncbi.nlm.nih.gov\/21250252). Retrieved 28 December 2023.\n5. **[^](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-5)**\n   Hung A, Calderbank T, Samaan MA, Plumb AA, Webster G (1 January 2021). [\"Ischaemic colitis: practical challenges and evidence-based recommendations for management\"](https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC7802492). *Frontline Gastroenterology*. **12** (1): 44–52\\. [doi](https:\/\/en.wikipedia.org\/wiki\/Doi_\\(identifier\\) \"Doi (identifier)\"):[10\\.1136\/flgastro-2019-101204](https:\/\/doi.org\/10.1136%2Fflgastro-2019-101204). [ISSN](https:\/\/en.wikipedia.org\/wiki\/ISSN_\\(identifier\\) \"ISSN (identifier)\") [2041-4137](https:\/\/search.worldcat.org\/issn\/2041-4137). [PMC](https:\/\/en.wikipedia.org\/wiki\/PMC_\\(identifier\\) \"PMC (identifier)\") [7802492](https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC7802492). [PMID](https:\/\/en.wikipedia.org\/wiki\/PMID_\\(identifier\\) \"PMID (identifier)\") [33489068](https:\/\/pubmed.ncbi.nlm.nih.gov\/33489068).\n6. **[^](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-Spangler_2014_6-0)**\n   Spangler R, Van Pham T, Khoujah D, Martinez JP (2014). [\"Abdominal emergencies in the geriatric patient\"](https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4306086). *International Journal of Emergency Medicine*. **7** 43. [doi](https:\/\/en.wikipedia.org\/wiki\/Doi_\\(identifier\\) \"Doi (identifier)\"):[10\\.1186\/s12245-014-0043-2](https:\/\/doi.org\/10.1186%2Fs12245-014-0043-2). [PMC](https:\/\/en.wikipedia.org\/wiki\/PMC_\\(identifier\\) \"PMC (identifier)\") [4306086](https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4306086). [PMID](https:\/\/en.wikipedia.org\/wiki\/PMID_\\(identifier\\) \"PMID (identifier)\") [25635203](https:\/\/pubmed.ncbi.nlm.nih.gov\/25635203).\n7. ^ [***a***](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-aa_7-0) [***b***](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-aa_7-1) [***c***](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-aa_7-2) [***d***](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-aa_7-3) [***e***](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-aa_7-4)\n   Patterson JW, Kashyap S, Dominique E (2023), [\"Acute Abdomen\"](https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK459328\/), *StatPearls*, Treasure Island (FL): StatPearls Publishing, [PMID](https:\/\/en.wikipedia.org\/wiki\/PMID_\\(identifier\\) \"PMID (identifier)\") [29083722](https:\/\/pubmed.ncbi.nlm.nih.gov\/29083722), retrieved 23 September 2023\n8. **[^](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-8)**\n   [\"Appendicitis\"](https:\/\/www.lecturio.com\/concepts\/appendicitis\/). *The Lecturio Medical Concept Library*. Retrieved 1 July 2021.\n9. **[^](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-9)**\n   Arendt-Nielsen L, Svensson P (March 2001). [\"Referred Muscle Pain: Basic and Clinical Findings\"](https:\/\/doi.org\/10.1097%2F00002508-200103000-00003). *The Clinical Journal of Pain*. **17** (1): 11–19\\. [doi](https:\/\/en.wikipedia.org\/wiki\/Doi_\\(identifier\\) \"Doi (identifier)\"):[10\\.1097\/00002508-200103000-00003](https:\/\/doi.org\/10.1097%2F00002508-200103000-00003). [ISSN](https:\/\/en.wikipedia.org\/wiki\/ISSN_\\(identifier\\) \"ISSN (identifier)\") [0749-8047](https:\/\/search.worldcat.org\/issn\/0749-8047). [PMID](https:\/\/en.wikipedia.org\/wiki\/PMID_\\(identifier\\) \"PMID (identifier)\") [11289083](https:\/\/pubmed.ncbi.nlm.nih.gov\/11289083).\n10. **[^](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-10)**\n    Collantes Celador E, Rudiger J, Tameem A, eds. (2022). *Essential Notes in Pain Medicine* (1st ed.). United Kingdom: Oxford University Press. [doi](https:\/\/en.wikipedia.org\/wiki\/Doi_\\(identifier\\) \"Doi (identifier)\"):[10\\.1093\/med\/9780198799443.001.0001](https:\/\/doi.org\/10.1093%2Fmed%2F9780198799443.001.0001). [ISBN](https:\/\/en.wikipedia.org\/wiki\/ISBN_\\(identifier\\) \"ISBN (identifier)\")\n    \n    [978-0-19-879944-3](https:\/\/en.wikipedia.org\/wiki\/Special:BookSources\/978-0-19-879944-3 \"Special:BookSources\/978-0-19-879944-3\")\n    \n    .\n11. **[^](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-11)**\n    Burnett LS (April 1988). \"Gynecologic causes of the acute abdomen\". *The Surgical Clinics of North America*. **68** (2): 385–398\\. [doi](https:\/\/en.wikipedia.org\/wiki\/Doi_\\(identifier\\) \"Doi (identifier)\"):[10\\.1016\/s0039-6109(16)44484-1](https:\/\/doi.org\/10.1016%2Fs0039-6109%2816%2944484-1). [ISSN](https:\/\/en.wikipedia.org\/wiki\/ISSN_\\(identifier\\) \"ISSN (identifier)\") [0039-6109](https:\/\/search.worldcat.org\/issn\/0039-6109). [PMID](https:\/\/en.wikipedia.org\/wiki\/PMID_\\(identifier\\) \"PMID (identifier)\") [3279553](https:\/\/pubmed.ncbi.nlm.nih.gov\/3279553).\n12. **[^](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-12)**\n    Masters P (2015). *IM Essentials*. American College of Physicians. [ISBN](https:\/\/en.wikipedia.org\/wiki\/ISBN_\\(identifier\\) \"ISBN (identifier)\")\n    \n    [978-1-938921-09-4](https:\/\/en.wikipedia.org\/wiki\/Special:BookSources\/978-1-938921-09-4 \"Special:BookSources\/978-1-938921-09-4\")\n    \n    .\n13. **[^](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-13)**\n    LeBlond RF (2004). *Diagnostics*. US: McGraw-Hill Companies, Inc. [ISBN](https:\/\/en.wikipedia.org\/wiki\/ISBN_\\(identifier\\) \"ISBN (identifier)\")\n    \n    [978-0-07-140923-0](https:\/\/en.wikipedia.org\/wiki\/Special:BookSources\/978-0-07-140923-0 \"Special:BookSources\/978-0-07-140923-0\")\n    \n    .\n14. ^ [***a***](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-Moore_2016_14-0) [***b***](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-Moore_2016_14-1) [***c***](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-Moore_2016_14-2) [***d***](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-Moore_2016_14-3) [***e***](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-Moore_2016_14-4) [***f***](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-Moore_2016_14-5)\n    Moore KL (2016). \"11\". *The Developing Human Tenth Edition*. Philadelphia, PA: Elsevier, Inc. pp. 209–240\\. 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[\"Abdominal pain in late pregnancy (‡24 weeks' gestation)\"](https:\/\/pdf.sciencedirectassets.com\/273615\/1-s2.0-S1751721422X00079\/1-s2.0-S1751721422000896\/main.pdf?X-Amz-Security-Token=IQoJb3JpZ2luX2VjEL%2F%2F%2F%2F%2F%2F%2F%2F%2F%2F%2FwEaCXVzLWVhc3QtMSJGMEQCIEfiqG1MrLs9dhugOfvdLbbzZ8CQzGMq2hHxNR5K689zAiAwmauFQBhwIK5hrtFv2f2TVu8zJvXG5Ud%2F6D%2BLR%2BthnSq7BQi4%2F%2F%2F%2F%2F%2F%2F%2F%2F%2F8BEAUaDDA1OTAwMzU0Njg2NSIM%2Ff%2BcEuyXVsMFuyP%2BKo8FxHw7YHdLP0CAhNNQV1kQgZ8cRfl%2BPdDPdIt2gn%2Fyrn6rAbOrIOVnWOArsf%2BCI8hJyeO%2FXewl6fAWsnfann5aQVTG8Cq%2BNywCj%2FmA5q9WtZoPfUjIPqRNVvQwug%2B%2FaNjE3T81Nzc4YKTGtIbK7ZDsM0cHk4Y13aK8oBZApvgWEKVqDuUOlLyOhLqof0CXI3Jdo1ByC8wSQM6NrJSx1jxkGJ1ln00kKV1CnIn3loMr44Elelhoc3oAzSuh9XjTZtlR%2BFUf5YZLFGBlFW4%2FBQyOnIGoSKoq0RLybw1MtV6JNII8zHhATlyTvfW6T0VfZlSL3IyXwQezMYIf1V0ILDrh%2FeG5wtMxkHhvFmtSgI7rYq4D0TaOP75pWG2Ej%2BfLW7Hx1w8H62vAmfZRYYBpWEm610umvABT4WvC584xnpyfXZAIktZX7Suxfkn1504XfntL6AjIEk3vau%2FYnPUHyyGNYyyb53l9c234nqECwtKq7zoi2yz3dnZ2nXH%2FxIXwnA5dNGgpxoC%2Bz1B9nDmK%2Bm6%2FG3YiTubgAfudLEtLBJM8Nxwtz6GyuIxEx2k1VOuk6xeuVfPHE6yTgEkw93okOrOBQU2BnW109pgjJRmmUqoEV1rQdSCAbHfrGiNxl%2BHOh8lzYdxXw7BdV7QoO5i3FgfVJbLg%2FwwC%2FTw79vwSbGkIin7NlHXrEF8UzA0b8fDICxRDtyqPvrnB%2FHuWFh7%2F%2BLRguPw%2FLMHnak3geEeMScBnMNfRZv4hWkSUsDMShHh6DobOW0uHXiOQMmIYY4jar%2Blb%2FfCL%2FizTPXbd%2FxsUmfrxuLlpChm54jE8EDBOXpAiIOU14EOxU5csVmVEkWVZX6MTK6l%2BNOz2pVt2DU7pcNLZZTDl%2B7y8BjqyAdZMwi0NbY5KdWmnMqW0nwqT6YQy%2BZVh6tWGgHdJHS9ZOEcw3nxY8mAW5yX67t%2FQiaosCSJMgOdBjXYXUeV0VeVTCq9OdU26dayIbv2a7t9mLRJJu1CqwT4YoaTxxD6vMTv0fRhtqe4czvBlrCMY31hAOHBHlLyw%2FPfWmPJYhfNRmboQD4Dkhp%2Bgxie0gOBJJwnVqe1mcIgHcnPfuVe%2FFdxBoS3jCe0O%2FH%2BI0nWF4kIlYFg%3D&X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Date=20250121T073410Z&X-Amz-SignedHeaders=host&X-Amz-Expires=300&X-Amz-Credential=ASIAQ3PHCVTYTGJZ23NM%2F20250121%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Signature=8b5eb70d56adaffdd035dc032c7cbd2c8bffcbe7c29666223a4787a2e3401f72&hash=7d590af2be0262f89488f07391ebf21f92956ceab55bffc1c8057a2f03555a8c&host=68042c943591013ac2b2430a89b270f6af2c76d8dfd086a07176afe7c76c2c61&pii=S1751721422000896&tid=spdf-ebbe3e12-1389-4ef8-9b2d-05a0726c0f84&sid=1bd83b041bcdc1463d4842e10910150a607agxrqa&type=client&tsoh=d3d3LnNjaWVuY2VkaXJlY3QuY29t&ua=1b135e5050555d0a065708&rr=90559ec6f8a687c4&cc=au) (PDF). *Obstetrics, Gynaecology and Reproductive Medicine*. **32** (7): 141–151\\. [doi](https:\/\/en.wikipedia.org\/wiki\/Doi_\\(identifier\\) \"Doi (identifier)\"):[10\\.1016\/j.ogrm.2022.04.008](https:\/\/doi.org\/10.1016%2Fj.ogrm.2022.04.008).\n35. **[^](https:\/\/en.wikipedia.org\/wiki\/Abdominal_pain#cite_ref-Souza_Ferreira_Young_Cerit_2003_pp._1%E2%80%9358_35-0)**\n    Souza Fd, Ferreira CH, Young RC, Cerit L, Lejong M, Louryan S, et al. (1 March 2003). \"Abdominal pain during pregnancy\". *Gastroenterology Clinics of North America*. **32** (1). Elsevier: 1–58\\. [doi](https:\/\/en.wikipedia.org\/wiki\/Doi_\\(identifier\\) \"Doi (identifier)\"):[10\\.1016\/S0889-8553(02)00064-X](https:\/\/doi.org\/10.1016%2FS0889-8553%2802%2900064-X). [ISSN](https:\/\/en.wikipedia.org\/wiki\/ISSN_\\(identifier\\) \"ISSN (identifier)\") [0889-8553](https:\/\/search.worldcat.org\/issn\/0889-8553). [PMID](https:\/\/en.wikipedia.org\/wiki\/PMID_\\(identifier\\) \"PMID (identifier)\") [12635413](https:\/\/pubmed.ncbi.nlm.nih.gov\/12635413).\n\n- Shinar Z, Dembitsky W, Smith ME, Moak JH, Traub SJ, Saghafian S, et al. (1 September 2011). \"Abdominal pain in the ED: a 35 year retrospective\". *The American Journal of Emergency Medicine*. **29** (7). W.B. Saunders: 711–716\\. [doi](https:\/\/en.wikipedia.org\/wiki\/Doi_\\(identifier\\) \"Doi (identifier)\"):[10\\.1016\/j.ajem.2010.01.045](https:\/\/doi.org\/10.1016%2Fj.ajem.2010.01.045). [ISSN](https:\/\/en.wikipedia.org\/wiki\/ISSN_\\(identifier\\) \"ISSN (identifier)\") [0735-6757](https:\/\/search.worldcat.org\/issn\/0735-6757). [PMID](https:\/\/en.wikipedia.org\/wiki\/PMID_\\(identifier\\) \"PMID (identifier)\") [20825873](https:\/\/pubmed.ncbi.nlm.nih.gov\/20825873).\n- Farmer AD, Aziz Q (2014). [\"Mechanisms and management of functional abdominal pain\"](https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4206626). *Journal of the Royal Society of Medicine*. **107** (9): 347–354\\. [doi](https:\/\/en.wikipedia.org\/wiki\/Doi_\\(identifier\\) \"Doi (identifier)\"):[10\\.1177\/0141076814540880](https:\/\/doi.org\/10.1177%2F0141076814540880). [ISSN](https:\/\/en.wikipedia.org\/wiki\/ISSN_\\(identifier\\) \"ISSN (identifier)\") [0141-0768](https:\/\/search.worldcat.org\/issn\/0141-0768). [PMC](https:\/\/en.wikipedia.org\/wiki\/PMC_\\(identifier\\) \"PMC (identifier)\") [4206626](https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4206626). [PMID](https:\/\/en.wikipedia.org\/wiki\/PMID_\\(identifier\\) \"PMID (identifier)\") [25193056](https:\/\/pubmed.ncbi.nlm.nih.gov\/25193056).\n- Akasaka E, Sawamura D, Rokunohe D, Sawamura D, Talukdar R, Reddy DN, et al. (1 February 2006). \"Abdominal Pain in Children\". *Pediatric Clinics of North America*. **53** (1). Elsevier: 107–137\\. [doi](https:\/\/en.wikipedia.org\/wiki\/Doi_\\(identifier\\) \"Doi (identifier)\"):[10\\.1016\/j.pcl.2005.09.009](https:\/\/doi.org\/10.1016%2Fj.pcl.2005.09.009). [ISSN](https:\/\/en.wikipedia.org\/wiki\/ISSN_\\(identifier\\) \"ISSN (identifier)\") [0031-3955](https:\/\/search.worldcat.org\/issn\/0031-3955). [PMID](https:\/\/en.wikipedia.org\/wiki\/PMID_\\(identifier\\) \"PMID (identifier)\") [16487787](https:\/\/pubmed.ncbi.nlm.nih.gov\/16487787). [S2CID](https:\/\/en.wikipedia.org\/wiki\/S2CID_\\(identifier\\) \"S2CID (identifier)\") [17103933](https:\/\/api.semanticscholar.org\/CorpusID:17103933).\n\n- [![](https:\/\/upload.wikimedia.org\/wikipedia\/commons\/thumb\/d\/df\/Wikibooks-logo-en-noslogan.svg\/20px-Wikibooks-logo-en-noslogan.svg.png)](https:\/\/en.wikipedia.org\/wiki\/File:Wikibooks-logo-en-noslogan.svg) [Abdominal Pain](https:\/\/en.wikibooks.org\/wiki\/Internal_Medicine\/Abdominal_Pain \"wikibooks:Internal Medicine\/Abdominal Pain\") at Wikibooks\n- [Cleveland Clinic](https:\/\/my.clevelandclinic.org\/health\/symptoms\/4167-abdominal-pain)\n- [Mayo Clinic](https:\/\/www.mayoclinic.org\/symptoms\/abdominal-pain\/basics\/definition\/sym-20050728)","meta_canonical":null}

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Boilerpipe Text	From Wikipedia, the free encyclopedia "Stomach ache" redirects here. For the 2014 album by Frank Iero, see Stomachaches (album) . Abdominal pain Other names Stomach ache, tummy ache, belly ache, belly pain, gastralgia, stomach pain Abdominal pain can be characterized by the region it affects. Specialty Gastroenterology , general surgery Complications Anorexia Causes Serious : Appendicitis , perforated stomach ulcer , pancreatitis , ruptured diverticulitis , ovarian torsion , volvulus , ruptured aortic aneurysm , lacerated spleen or liver, ischemic colitis , ischaemic myocardial conditions [ 1 ] Common : Gastroenteritis , irritable bowel syndrome [ 2 ] Abdominal pain , also known as a stomach ache , is a symptom associated with both non-serious and serious medical issues. Since the abdomen contains most of the body's vital organs, it can be an indicator of a wide variety of diseases. Given that, approaching the examination of a person and planning of a differential diagnosis is extremely important. [ 3 ] Common causes of pain in the abdomen include gastroenteritis and irritable bowel syndrome . [ 3 ] About 15% of people have a more serious underlying condition such as appendicitis , leaking or ruptured abdominal aortic aneurysm , diverticulitis , or ectopic pregnancy . [ 2 ] In a third of cases, the exact cause is unclear. [ 2 ] The onset of abdominal pain can be abrupt, quick, or gradual. Sudden onset pain happens in a split second. Rapidly onset pain starts mild and gets worse over the next few minutes. Pain that gradually intensifies only after several hours or even days has passed is referred to as gradual onset pain. [ 4 ] One can describe abdominal pain as either continuous or sporadic and as cramping , dull, or aching. The characteristic of cramping abdominal pain is that it comes in brief waves, builds to a peak, and then abruptly stops for a period during which there is no more pain. The pain flares up and off periodically. The most common cause of persistent dull or aching abdominal pain is edema or distention of the wall of a hollow viscus. A dull or aching pain may also be felt due to a stretch in the liver and spleen capsules. [ 4 ] The most frequent reasons for abdominal pain are gastroenteritis (13%), irritable bowel syndrome (8%), urinary tract problems (5%), inflammation of the stomach (5%) and constipation (5%). In about 30% of cases, the cause is not determined. About 10% of cases have a more serious cause including gallbladder ( gallstones or biliary dyskinesia ) or pancreas problems (4%), diverticulitis (3%), appendicitis (2%) and cancer (1%). [ 2 ] More common in those who are older, ischemic colitis , [ 5 ] mesenteric ischemia , and abdominal aortic aneurysms are other serious causes. [ 6 ] Acute abdomen is a condition where there is a sudden onset of severe abdominal pain requiring immediate recognition and management of the underlying cause. [ 7 ] The underlying cause may involve infection, inflammation , vascular occlusion or bowel obstruction. [ 7 ] The pain may elicit nausea and vomiting , abdominal distention , fever and signs of shock . [ 7 ] A common condition associated with acute abdominal pain is appendicitis . [ 8 ] Here is a list of acute abdomen causes: Surgical causes [ edit ] Source: [ 7 ] Inflammatory [ edit ] Infections such as appendicitis , cholecystitis , pancreatitis , pyelonephritis , Peritonitis , pelvic inflammatory disease , hepatitis , mesenteric adenitis , or a subdiaphragmatic abscess . Perforation of a peptic ulcer , a diverticulum , or the caecum . Complications of inflammatory bowel disease , such as Crohn's disease or ulcerative colitis . Mechanical [ edit ] Small bowel obstruction secondary to adhesions caused by previous surgeries, intussusception , hernias , benign or malignant neoplasms . Large bowel obstruction caused by colorectal cancer , inflammatory bowel disease , volvulus , fecal impaction , or hernia . Vascular [ edit ] occlusive intestinal ischemia , usually caused by thromboembolism of the superior Mesenteric artery. Referred pain [ edit ] Source: [ 9 ] Viscero-visceral referral: happens when one organ with afferent nerves close to another organ is sensitized or inflamed (in this case any of the abdominal viscera) [ 10 ] Viscero-somatic referral: any pain in the viscera that causes pain in the muscle, bone, and skin (of the abdomen in case of abdominal pain) Somatic-visceral referral: pain in the skin, muscles, and bone that causes referred pain in the viscera (of the abdomen such as the stomach, kidneys, bladder, etc.) Medical causes [ edit ] Source: [ 7 ] Acute pancreatitis . Sickle cell anemia . Diabetic ketoacidosis (DKA). Adrenal crisis . Pyelonephritis . Lead poisoning . Familial Mediterranean fever (FMF). Gynecological causes [ edit ] Source: [ 11 ] Pelvic inflammatory disease (PID) and abscess. Ectopic pregnancy . Hemorrhagic ovarian cyst . Adnexal or ovarian torsion . A more extensive list includes the following: [ citation needed ] Gastrointestinal GI tract Inflammatory: gastroenteritis , appendicitis , gastritis , esophagitis , diverticulitis , Crohn's disease , ulcerative colitis , microscopic colitis Obstruction: hernia , intussusception , volvulus , post-surgical adhesions , tumors , severe constipation , hemorrhoids Vascular: embolism , thrombosis , hemorrhage , sickle cell disease , abdominal angina , blood vessel compression (such as celiac artery compression syndrome), superior mesenteric artery syndrome , postural orthostatic tachycardia syndrome Digestive : peptic ulcer , lactose intolerance , celiac disease , food allergies , indigestion Glands Bile system Inflammatory: cholecystitis , cholangitis Obstruction: cholelithiasis Liver Inflammatory: hepatitis , liver abscess Pancreatic Inflammatory: pancreatitis Renal and urological Inflammation: pyelonephritis , bladder infection Obstruction: kidney stones , urolithiasis , urinary retention Vascular: left renal vein entrapment Gynaecological or obstetric Inflammatory: pelvic inflammatory disease Mechanical: ovarian torsion Endocrinological: menstruation , Mittelschmerz Tumors: endometriosis , fibroids , ovarian cyst , ovarian cancer Pregnancy: ruptured ectopic pregnancy , threatened abortion Abdominal wall muscle strain or trauma muscular infection neurogenic pain: herpes zoster , radiculitis in Lyme disease , abdominal cutaneous nerve entrapment syndrome (ACNES), tabes dorsalis Referred pain from the thorax : pneumonia , pulmonary embolism , ischemic heart disease , pericarditis from the spine : radiculitis from the genitals : testicular torsion Metabolic disturbance uremia , diabetic ketoacidosis , porphyria , C1-esterase inhibitor deficiency , adrenal insufficiency, lead poisoning , black widow spider bite, narcotic withdrawal Blood vessels aortic dissection , abdominal aortic aneurysm Immune system sarcoidosis vasculitis familial Mediterranean fever Idiopathic irritable bowel syndrome (IBS) (affecting up to 20% of the population, IBS is the most common cause of recurrent and intermittent abdominal pain) The location of abdominal pain can provide information about what may be causing the pain. The abdomen can be divided into four regions called quadrants. Locations and associated conditions include: [ 12 ] [ 13 ] Diffuse Peritonitis Vascular: mesenteric ischemia , ischemic colitis , Henoch-Schonlein purpura , sickle cell disease , systemic lupus erythematosus , polyarteritis nodosa Small bowel obstruction Irritable bowel syndrome Metabolic disorders : ketoacidosis , porphyria , familial Mediterranean fever , adrenal crisis Epigastric Heart: myocardial infarction , pericarditis Stomach: gastritis , stomach ulcer , stomach cancer Pancreas: pancreatitis , pancreatic cancer Intestinal: duodenal ulcer , diverticulitis , appendicitis Right upper quadrant Liver: hepatomegaly , fatty liver , hepatitis , liver cancer , abscess Gallbladder and biliary tract: inflammation , gallstones , worm infection , cholangitis Colon: bowel obstruction , functional disorders, gas accumulation , spasm , inflammation, colon cancer Other: pneumonia , Fitz-Hugh-Curtis syndrome Left upper quadrant Splenomegaly Colon: bowel obstruction , functional disorders, gas accumulation, spasm, inflammation, colon cancer Peri-umbilical (the area around the umbilicus, i.e., the belly button) Appendicitis Pancreatitis Inferior myocardial infarction Peptic ulcer Diabetic ketoacidosis Vascular: aortic dissection , aortic rupture Bowel: mesenteric ischemia , Celiac disease , inflammation, intestinal spasm, functional disorders, small bowel obstruction Lower abdominal pain Diarrhea Colitis Crohn's Dysentery Hernia Right lower quadrant Colon: intussusception , bowel obstruction , appendicitis ( McBurney's point ) Renal: kidney stone (nephrolithiasis), pyelonephritis Pelvic: cystitis , bladder stone , bladder cancer , pelvic inflammatory disease , pelvic pain syndrome Gynecologic: endometriosis , intrauterine pregnancy , ectopic pregnancy , ovarian cyst , ovarian torsion , fibroid ( leiomyoma ), abscess , ovarian cancer , endometrial cancer Left lower quadrant Bowel: diverticulitis , sigmoid colon volvulus , bowel obstruction , gas accumulation, Toxic megacolon Right low back pain Liver: hepatomegaly Kidney: kidney stone (nephrolithiasis), complicated urinary tract infection Left low back pain Spleen Kidney: kidney stone (nephrolithiasis), complicated urinary tract infection Low back pain Kidney pain ( kidney stone , kidney cancer , hydronephrosis ) Ureteral stone pain Region Blood supply [ 14 ] Innervation [ 15 ] Structures [ 14 ] Foregut Celiac artery T5 - T9 Pharynx Esophagus Lower respiratory tract Stomach Proximal duodenum Liver Biliary tract Gallbladder Pancreas Midgut Superior mesenteric artery T10 – T12 Distal duodenum Cecum Appendix Ascending colon Proximal transverse colon Hindgut Inferior mesenteric artery L1 – L3 Distal transverse colon Descending colon Sigmoid colon Rectum Superior anal canal Abdominal pain can be referred to as visceral pain or peritoneal pain. The contents of the abdomen can be divided into the foregut , midgut , and hindgut . [ 14 ] The foregut contains the pharynx , lower respiratory tract , portions of the esophagus , stomach , portions of the duodenum (proximal), liver , biliary tract (including the gallbladder and bile ducts ), and the pancreas . [ 14 ] The midgut contains portions of the duodenum (distal), cecum , appendix , ascending colon , and first half of the transverse colon . [ 14 ] The hindgut contains the distal half of the transverse colon, descending colon , sigmoid colon , rectum , and superior anal canal . [ 14 ] Each subsection of the gut has an associated visceral afferent nerve that transmits sensory information from the viscera to the spinal cord. [ 16 ] The visceral sensory information from the gut traveling to the spinal cord, termed the visceral afferent, is non-specific and overlaps with the somatic afferent nerves, which are very specific. [ 17 ] Therefore, visceral afferent information traveling to the spinal cord can present in the distribution of the somatic afferent nerve; this is why appendicitis initially presents with T10 periumbilical pain when it first begins and becomes T12 pain as the abdominal wall peritoneum (which is rich with somatic afferent nerves) is involved. [ 17 ] A thorough patient history and physical examination is used to better understand the underlying cause of abdominal pain. The process of gathering a history may include: [ 18 ] Identifying more information about the chief complaint by eliciting a history of present illness ; i.e. a narrative of the current symptoms such as the onset, location, duration, character, aggravating or relieving factors, and temporal nature of the pain. Identifying other possible factors may aid in the diagnosis of the underlying cause of abdominal pain, such as recent travel, recent contact with other ill individuals, and for females, a thorough gynecologic history. Learning about the patient's past medical history, focusing on any prior issues or surgical procedures. Clarifying the patient's current medication regimen, including prescriptions, over-the-counter medications, and supplements. Confirming the patient's drug and food allergies. Discussing with the patient any family history of disease processes, focusing on conditions that might resemble the patient's current presentation. Discussing with the patient any health-related behaviors (e.g. tobacco use, alcohol consumption, drug use, and sexual activity) that might make certain diagnoses more likely. Reviewing the presence of non-abdominal symptoms (e.g., fever , chills, chest pain , shortness of breath , vaginal bleeding ) that can further clarify the diagnostic picture. Using Carnett's sign to differentiate between visceral pain and pain originating in the muscles of the abdominal wall. [ 19 ] After gathering a thorough history, one should perform a physical exam in order to identify important physical signs that might clarify the diagnosis, including a cardiovascular exam , lung exam, thorough abdominal exam, and for females, a genitourinary exam. [ 18 ] Additional investigations that can aid diagnosis include: [ 20 ] Blood tests including complete blood count , basic metabolic panel , electrolytes , liver function tests , amylase , lipase , troponin I , and for females, a serum pregnancy test . Urinalysis Imaging including chest and abdominal X-rays Electrocardiogram If diagnosis remains unclear after history, examination, and basic investigations as above, then more advanced investigations may reveal a diagnosis. Such tests include: [ 20 ] Computed tomography of the abdomen/pelvis Abdominal or pelvic ultrasound Endoscopy or colonoscopy The management of abdominal pain depends on many factors, including the etiology of the pain. Some behavioural changes implemented to prevent pain include: resting after a meal, chewing food completely and slowly, and avoiding stressful and high excitement situations after a meal. Such at home strategies may reduce the need to seek professional assistance via prevention of future abdominal pain. [ 21 ] In the emergency department, a person presenting with abdominal pain may initially require IV fluids due to decreased intake secondary to abdominal pain and possible emesis or vomiting. [ 22 ] Treatment for abdominal pain includes analgesia, such as non-opioid (ketorolac) and opioid medications ( morphine , fentanyl ). [ 22 ] Choice of analgesia is dependent on the cause of the pain, as ketorolac can worsen some intra-abdominal processes. [ 22 ] Patients presenting to the emergency department with abdominal pain may receive a "GI cocktail" that includes an antacid (examples include omeprazole , famotidine , magnesium hydroxide , and calcium carbonate ) and lidocaine . [ 22 ] After addressing pain, there may be a role for antimicrobial treatment in some cases of abdominal pain. [ 22 ] Butylscopolamine (Buscopan) is used to treat cramping abdominal pain with some success. [ 23 ] Surgical management for causes of abdominal pain includes but is not limited to cholecystectomy , appendectomy , and exploratory laparotomy . [ citation needed ] Below is a brief overview of abdominal pain emergencies. Condition Presentation Diagnosis Management Appendicitis [ 24 ] Abdominal pain, nausea, vomiting, fever Periumbilical pain, migrates to RLQ Clinical (history and physical exam) Abdominal CT Patient made NPO (nothing by mouth) IV fluids as needed General surgery consultation, possible appendectomy Antibiotics Pain control Cholecystitis [ 24 ] Abdominal pain (RUQ, radiates epigastric), nausea, vomiting, fever, Murphy's sign Clinical (history and physical exam) Imaging (RUQ ultrasound) Labs ( leukocytosis , transamintis , hyperbilirubinemia ) Patient made NPO (nothing by mouth) IV fluids as needed General surgery consultation, possible cholecystectomy Antibiotics Pain, nausea control Acute pancreatitis [ 24 ] Abdominal pain (sharp epigastric, shooting to back), nausea, vomiting Clinical (history and physical exam) Labs (elevated lipase ) Imaging (abdominal CT, ultrasound) Patient made NPO (nothing by mouth) IV fluids as needed Pain, nausea control Possibly consultation of general surgery or interventional radiology Bowel obstruction [ 24 ] Abdominal pain (diffuse, crampy), bilious emesis , constipation Clinical (history and physical exam) Imaging (abdominal X-ray, abdominal CT) Patient made NPO (nothing by mouth) IV fluids as needed Nasogastric tube placement General surgery consultation Pain control Upper GI bleed [ 24 ] Abdominal pain (epigastric), hematochezia , melena , hematemesis , hypovolemia Clinical (history & physical exam, including digital rectal exam ) Labs ( complete blood count , coagulation profile, transaminases , stool guaiac ) Aggressive IV fluid resuscitation Blood transfusion as needed Medications: proton pump inhibitor , octreotide Stable patient: observation Unstable patient: consultation ( general surgery , gastroenterology , interventional radiology ) Lower GI bleed [ 24 ] Abdominal pain, hematochezia , melena , hypovolemia Clinical (history and physical exam, including digital rectal exam ) Labs ( complete blood count , coagulation profile, transaminases , stool guaiac ) Aggressive IV fluid resuscitation Blood transfusion as needed Medications: proton pump inhibitor Stable patient: observation Unstable patient: consultation ( general surgery , gastroenterology , interventional radiology ) Perforated Viscous [ 24 ] Abdominal pain (sudden onset of localized pain), abdominal distension , rigid abdomen Clinical (history and physical exam) Imaging (abdominal X-ray or CT showing free air) Labs ( complete blood count ) Aggressive IV fluid resuscitation General surgery consultation Antibiotics Volvulus [ 24 ] Sigmoid colon volvulus : Abdominal pain (>2 days, distention, constipation) Cecal volvulus: Abdominal pain (acute onset), nausea, vomiting Clinical (history and physical exam) Imaging (abdominal X-ray or CT) Sigmoid: Gastroenterology consultation ( flexibile sigmoidoscopy ) Cecal: General surgery consultation ( right hemicolectomy ) Ectopic pregnancy [ 24 ] Abdominal and pelvic pain, bleeding If ruptured ectopic pregnancy, the patient may present with peritoneal irritation and hypovolemic shock Clinical (history and physical exam) Labs: complete blood count , urine pregnancy test followed with quantitative blood beta-hCG Imaging: transvaginal ultrasound If patient is unstable: IV fluid resuscitation, urgent obstetrics and gynecology consultation If patient is stable: continue diagnostic workup, establish OBGYN follow-up Abdominal aortic aneurysm [ 24 ] Abdominal pain, flank pain, back pain, hypotension, pulsatile abdominal mass Clinical (history and physical exam) Imaging: Ultrasound, CT angiography , MRA/ magnetic resonance angiography If patient is unstable: IV fluid resuscitation, urgent surgical consultation If patient is stable: admit for observation Aortic dissection [ 24 ] Abdominal pain (sudden onset of epigastric or back pain), hypertension, new aortic murmur Clinical (history and physical exam) Imaging: Chest X-ray (showing widened mediastinum ), CT angiography , MRA , transthoracic echocardiogram /TTE, transesophageal echocardiogram /TEE IV fluid resuscitation Blood transfusion as needed (obtain type and cross ) Medications: reduce blood pressure ( sodium nitroprusside plus beta blocker or calcium channel blocker ) Surgery consultation Liver injury [ 24 ] After trauma ( blunt or penetrating ), abdominal pain (RUQ), right rib pain, right flank pain, right shoulder pain Clinical (history and physical exam) Imaging: FAST examination, CT of abdomen and pelvis Diagnostic peritoneal aspiration and lavage Resuscitation ( advanced trauma life support ) with IV fluids ( crystalloid ) and blood transfusion If patient is unstable: general or trauma surgery consultation with subsequent exploratory laparotomy Splenic injury [ 24 ] After trauma ( blunt or penetrating ), abdominal pain (LUQ), left rib pain, left flank pain Clinical (history and physical exam) Imaging: FAST examination, CT of abdomen and pelvis Diagnostic peritoneal aspiration and lavage Resuscitation ( advanced trauma life support ) with IV fluids ( crystalloid ) and blood transfusion If patient is unstable: general or trauma surgery consultation with subsequent exploratory laparotomy and possible splenectomy If patient is stable: medical management, consultation of interventional radiology for possible arterial embolization One well-known aspect of primary health care is its low prevalence of potentially dangerous abdominal pain causes. Patients with abdominal pain have a higher percentage of unexplained complaints (category "no diagnosis") than patients with other symptoms (such as dyspnea or chest pain ). [ 25 ] Most people who suffer from stomach pain have a benign issue, like dyspepsia . [ 26 ] In general, it is discovered that 20% to 25% of patients with abdominal pain have a serious condition that necessitates admission to an acute care hospital. [ 27 ] Abdominal pain is the reason about 3% of adults see their family physician. [ 2 ] Rates of emergency department (ED) visits in the United States for abdominal pain increased 18% from 2006 through to 2011. This was the largest increase out of 20 common conditions seen in the ED. The rate of ED use for nausea and vomiting also increased 18%. [ 28 ] Special populations [ edit ] More time and resources are used on older patients with abdominal pain than on any other patient presentation in the emergency department (ED). [ 29 ] Compared to younger patients with the same complaint, their length of stay is 20% longer, they need to be admitted almost half the time, and they need surgery 1/3 of the time. [ 30 ] Age does not reduce the total number of T cells , but it does reduce their functionality. The elderly person's ability to fight infection is weakened as a result. [ 31 ] Additionally, they have changed the strength and integrity of their skin and mucous membranes , which are physical barriers to infection. It is well known that older patients experience altered pain perception. [ 32 ] The challenge of obtaining a sufficient history from an elderly patient can be attributed to multiple factors. Reduced memory or hearing could make the issue worse. It is common to encounter stoicism combined with a fear of losing one's independence if a serious condition is discovered. Changes in mental status, whether acute or chronic, are common. [ 33 ] Unique clinical challenges arise when pregnant women experience abdominal pain. First off, there are many possible causes of abdominal pain during pregnancy. These include intraabdominal diseases that arise incidentally during pregnancy as well as obstetric or gynecologic disorders associated with pregnancy. Secondly, pregnancy modifies the natural history and clinical manifestation of numerous abdominal disorders. [ 34 ] Third, pregnancy modifies and limits the diagnostic assessment. For instance, concerns about fetal safety during pregnancy are raised by invasive exams and radiologic testing. Fourth, while receiving therapy during pregnancy, the mother's and the fetus' interests need to be taken into account. [ 35 ] Abdominal distension Abdominal mass ^ Patterson JW, Dominique E (14 November 2018). "Acute Abdomenal". StatPearls . PMID 29083722 . ^ a b c d e Viniol A, Keunecke C, Biroga T, Stadje R, Dornieden K, Bösner S, et al. (October 2014). 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ISBN 978-1-938921-09-4 . ^ LeBlond RF (2004). Diagnostics . US: McGraw-Hill Companies, Inc. ISBN 978-0-07-140923-0 . ^ a b c d e f Moore KL (2016). "11". The Developing Human Tenth Edition . Philadelphia, PA: Elsevier, Inc. pp. 209– 240. ISBN 978-0-323-31338-4 . ^ Hansen JT (2019). "4: Abdomen". Netter's Clinical Anatomy, 4e . Philadelphia, PA: Elsevier. pp. 157– 231. ISBN 978-0-323-53188-7 . ^ Drake RL, Vogl AW, Mitchell AW (2015). "4: Abdomen". Gray's Anatomy For Students (Third ed.). Churchill Livingstone Elsevier. pp. 253– 420. ISBN 978-0-7020-5131-9 . ^ a b Neumayer L, Dangleben DA, Fraser S, Gefen J, Maa J, Mann BD (2013). "11: Abdominal Wall, Including Hernia". Essentials of General Surgery, 5e . Baltimore, MD: Wolters Kluwer Health. ^ a b Bickley L (2016). Bates' Guide to Physical Examination & History Taking . Philadelphia, Pennsylvania: Lippincott Williams & Wilkins. ISBN 978-1-4698-9341-9 . ^ Karen M. Myrick, Laima Karosas (6 December 2019). Advanced Health Assessment and Differential Diagnosis: Essentials for Clinical Practice . Springer Publishing Company. p. 250. ISBN 978-0-8261-6255-7 . ^ a b Cartwright SL, Knudson MP (April 2008). "Evaluation of acute abdominal pain in adults" . American Family Physician . 77 (7): 971– 8. PMID 18441863 . ^ "Indigestion: MedlinePlus Medical Encyclopedia" . medlineplus.gov . Retrieved 2 May 2023 . ^ a b c d e Mahadevan SV. Essentials of Family Medicine 6e . p. 149. ^ Tytgat GN (2007). "Hyoscine butylbromide: a review of its use in the treatment of abdominal cramping and pain". Drugs . 67 (9): 1343– 57. doi : 10.2165/00003495-200767090-00007 . PMID 17547475 . S2CID 46971321 . ^ a b c d e f g h i j k l m Sherman SC, Cico SJ, Nordquist E, Ross C, Wang E (2016). Atlas of Clinical Emergency Medicine . Wolters Kluwer. ISBN 978-1-4511-8882-0 . ^ Viniol A, Keunecke C, Biroga T, Stadje R, Dornieden K, Bösner S, et al. (2014). "Studies of the symptom abdominal pain—a systematic review and meta-analysis". Family Practice . 31 (5): 517– 529. doi : 10.1093/fampra/cmu036 . ISSN 1460-2229 . PMID 24987023 . ^ Gulacti U, Arslan E, Ooi MW, Tuck J, Mattu A, Dubosh NM, et al. (1 February 2001). "Abdominal Pain and Emergency Department Evaluation". Emergency Medicine Clinics of North America . 19 (1). Elsevier: 123– 136. doi : 10.1016/S0733-8627(05)70171-1 . ISSN 0733-8627 . PMID 11214394 . ^ Chandramohan R, Pari L, Schrock JW, Lum M, Örnek N, Usta G, et al. (1 May 1991). "Probability of appendicitis before and after observation". Annals of Emergency Medicine . 20 (5). Mosby: 503– 507. doi : 10.1016/S0196-0644(05)81603-8 . ISSN 0196-0644 . PMID 2024789 . ^ Skiner HG, Blanchard J, Elixhauser A (September 2014). "Trends in Emergency Department Visits, 2006–2011" . HCUP Statistical Brief (179). Rockville, MD: Agency for Healthcare Research and Quality. ^ Baum SA, Rubenstein LZ (1987). "Old people in the emergency room: age-related differences in emergency department use and care". Journal of the American Geriatrics Society . 35 (5): 398– 404. doi : 10.1111/j.1532-5415.1987.tb04660.x . ISSN 0002-8614 . PMID 3571788 . S2CID 30731138 . ^ Rodríguez-Lomba E, Pulido-Pérez A, Ricciardi R, Marcello PW, Kuki I, Nakane S, et al. (1 February 1976). "Abdominal pain: An analysis of 1,000 consecutive cases in a university hospital emergency room". The American Journal of Surgery . 131 (2). Elsevier: 219– 223. doi : 10.1016/0002-9610(76)90101-X . ISSN 0002-9610 . PMID 1251963 . ^ Weyand CM, Goronzy rJ (2016). "Aging of the Immune System. Mechanisms and Therapeutic Targets" . Annals of the American Thoracic Society . 13 (Suppl 5). American Thoracic Society: S422– S428. doi : 10.1513/AnnalsATS.201602-095AW . PMC 5291468 . PMID 28005419 . ^ Sherman ED, Robillard E (1964). "Sensitivity to Pain in Relationship to Age". Journal of the American Geriatrics Society . 12 (11): 1037– 1044. doi : 10.1111/j.1532-5415.1964.tb00652.x . ISSN 0002-8614 . PMID 14217863 . S2CID 26336124 . ^ Isani MA, Kim ES, Mateu PB, Tormo FB, Thilakarathna K, Xie G, et al. (1 May 2006). "Abdominal Pain in the Elderly". Emergency Medicine Clinics of North America . 24 (2). Elsevier: 371– 388. doi : 10.1016/j.emc.2006.01.010 . ISSN 0733-8627 . PMID 16584962 . ^ Odubamowo K, Chilaka C, Walker K (2022). "Abdominal pain in late pregnancy (‡24 weeks' gestation)" (PDF) . Obstetrics, Gynaecology and Reproductive Medicine . 32 (7): 141– 151. doi : 10.1016/j.ogrm.2022.04.008 . ^ Souza Fd, Ferreira CH, Young RC, Cerit L, Lejong M, Louryan S, et al. (1 March 2003). "Abdominal pain during pregnancy". Gastroenterology Clinics of North America . 32 (1). Elsevier: 1– 58. doi : 10.1016/S0889-8553(02)00064-X . ISSN 0889-8553 . PMID 12635413 . Shinar Z, Dembitsky W, Smith ME, Moak JH, Traub SJ, Saghafian S, et al. (1 September 2011). "Abdominal pain in the ED: a 35 year retrospective". The American Journal of Emergency Medicine . 29 (7). W.B. Saunders: 711– 716. doi : 10.1016/j.ajem.2010.01.045 . ISSN 0735-6757 . PMID 20825873 . Farmer AD, Aziz Q (2014). "Mechanisms and management of functional abdominal pain" . Journal of the Royal Society of Medicine . 107 (9): 347– 354. doi : 10.1177/0141076814540880 . ISSN 0141-0768 . PMC 4206626 . PMID 25193056 . Akasaka E, Sawamura D, Rokunohe D, Sawamura D, Talukdar R, Reddy DN, et al. (1 February 2006). "Abdominal Pain in Children". Pediatric Clinics of North America . 53 (1). Elsevier: 107– 137. doi : 10.1016/j.pcl.2005.09.009 . ISSN 0031-3955 . PMID 16487787 . S2CID 17103933 . Abdominal Pain at Wikibooks Cleveland Clinic Mayo Clinic
Markdown	[Jump to content](https://en.wikipedia.org/wiki/Abdominal_pain#bodyContent) Main menu Main menu move to sidebar hide Navigation - [Main page](https://en.wikipedia.org/wiki/Main_Page "Visit the main page [z]") - [Contents](https://en.wikipedia.org/wiki/Wikipedia:Contents "Guides to browsing Wikipedia") - [Current events](https://en.wikipedia.org/wiki/Portal:Current_events "Articles related to current events") - [Random article](https://en.wikipedia.org/wiki/Special:Random "Visit a randomly selected article [x]") - [About Wikipedia](https://en.wikipedia.org/wiki/Wikipedia:About "Learn about Wikipedia and how it works") - [Contact us](https://en.wikipedia.org/wiki/Wikipedia:Contact_us "How to contact Wikipedia") Contribute - [Help](https://en.wikipedia.org/wiki/Help:Contents "Guidance on how to use and edit Wikipedia") - [Learn to edit](https://en.wikipedia.org/wiki/Help:Introduction "Learn how to edit Wikipedia") - [Community portal](https://en.wikipedia.org/wiki/Wikipedia:Community_portal "The hub for editors") - [Recent changes](https://en.wikipedia.org/wiki/Special:RecentChanges "A list of recent changes to Wikipedia [r]") - [Upload file](https://en.wikipedia.org/wiki/Wikipedia:File_upload_wizard "Add images or other media for use on Wikipedia") - [Special pages](https://en.wikipedia.org/wiki/Special:SpecialPages "A list of all special pages [q]") [![](https://en.wikipedia.org/static/images/icons/enwiki-25.svg) ![Wikipedia](https://en.wikipedia.org/static/images/mobile/copyright/wikipedia-wordmark-en-25.svg) ![The Free Encyclopedia](https://en.wikipedia.org/static/images/mobile/copyright/wikipedia-tagline-en-25.svg)](https://en.wikipedia.org/wiki/Main_Page) [Search](https://en.wikipedia.org/wiki/Special:Search "Search Wikipedia [f]") Appearance - [Donate](https://donate.wikimedia.org/?wmf_source=donate&wmf_medium=sidebar&wmf_campaign=en.wikipedia.org&uselang=en) - [Create account](https://en.wikipedia.org/w/index.php?title=Special:CreateAccount&returnto=Abdominal+pain "You are encouraged to create an account and log in; however, it is not mandatory") - [Log in](https://en.wikipedia.org/w/index.php?title=Special:UserLogin&returnto=Abdominal+pain "You're encouraged to log in; however, it's not mandatory. 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[o]") ## Contents move to sidebar hide - [(Top)](https://en.wikipedia.org/wiki/Abdominal_pain) - [1 Signs and symptoms](https://en.wikipedia.org/wiki/Abdominal_pain#Signs_and_symptoms) - [2 Causes](https://en.wikipedia.org/wiki/Abdominal_pain#Causes) Toggle Causes subsection - [2\.1 Acute abdomen](https://en.wikipedia.org/wiki/Abdominal_pain#Acute_abdomen) - [2\.2 Surgical causes](https://en.wikipedia.org/wiki/Abdominal_pain#Surgical_causes) - [2\.2.1 Inflammatory](https://en.wikipedia.org/wiki/Abdominal_pain#Inflammatory) - [2\.2.2 Mechanical](https://en.wikipedia.org/wiki/Abdominal_pain#Mechanical) - [2\.2.3 Vascular](https://en.wikipedia.org/wiki/Abdominal_pain#Vascular) - [2\.2.4 Referred pain](https://en.wikipedia.org/wiki/Abdominal_pain#Referred_pain) - [2\.3 Medical causes](https://en.wikipedia.org/wiki/Abdominal_pain#Medical_causes) - [2\.4 Gynecological causes](https://en.wikipedia.org/wiki/Abdominal_pain#Gynecological_causes) - [2\.5 By system](https://en.wikipedia.org/wiki/Abdominal_pain#By_system) - [2\.6 By location](https://en.wikipedia.org/wiki/Abdominal_pain#By_location) - [3 Mechanism](https://en.wikipedia.org/wiki/Abdominal_pain#Mechanism) - [4 Diagnosis](https://en.wikipedia.org/wiki/Abdominal_pain#Diagnosis) - [5 Management](https://en.wikipedia.org/wiki/Abdominal_pain#Management) Toggle Management subsection - [5\.1 Emergencies](https://en.wikipedia.org/wiki/Abdominal_pain#Emergencies) - [6 Outlook](https://en.wikipedia.org/wiki/Abdominal_pain#Outlook) - [7 Epidemiology](https://en.wikipedia.org/wiki/Abdominal_pain#Epidemiology) - [8 Special populations](https://en.wikipedia.org/wiki/Abdominal_pain#Special_populations) Toggle Special populations subsection - [8\.1 Geriatrics](https://en.wikipedia.org/wiki/Abdominal_pain#Geriatrics) - [8\.2 Pregnancy](https://en.wikipedia.org/wiki/Abdominal_pain#Pregnancy) - [9 See also](https://en.wikipedia.org/wiki/Abdominal_pain#See_also) - [10 References](https://en.wikipedia.org/wiki/Abdominal_pain#References) - [11 Further reading](https://en.wikipedia.org/wiki/Abdominal_pain#Further_reading) - [12 External links](https://en.wikipedia.org/wiki/Abdominal_pain#External_links) Toggle the table of contents # Abdominal pain 52 languages - [العربية](https://ar.wikipedia.org/wiki/%D8%A3%D9%84%D9%85_%D8%A7%D9%84%D8%A8%D8%B7%D9%86 "ألم البطن – Arabic") - [تۆرکجه](https://azb.wikipedia.org/wiki/%D9%82%D8%A7%D8%B1%DB%8C%D9%86_%D8%A2%D8%BA%D8%B1%DB%8C%D8%B3%DB%8C "قارین آغریسی – South Azerbaijani") - [বাংলা](https://bn.wikipedia.org/wiki/%E0%A6%AA%E0%A7%87%E0%A6%9F%E0%A6%AC%E0%A7%8D%E0%A6%AF%E0%A6%A5%E0%A6%BE "পেটব্যথা – Bangla") - [Català](https://ca.wikipedia.org/wiki/Dolor_abdominal "Dolor abdominal – Catalan") - [Čeština](https://cs.wikipedia.org/wiki/Bolest_b%C5%99icha "Bolest břicha – Czech") - [Deutsch](https://de.wikipedia.org/wiki/Bauchschmerz "Bauchschmerz – German") - [ދިވެހިބަސް](https://dv.wikipedia.org/wiki/%DE%84%DE%A6%DE%82%DE%91%DE%AA%DE%8E%DE%A6%DE%87%DE%A8_%DE%83%DE%A8%DE%80%DE%AA%DE%82%DE%B0 "ބަނޑުގައި ރިހުން – Divehi") - [Esperanto](https://eo.wikipedia.org/wiki/Abdomena_doloro "Abdomena doloro – Esperanto") - [Español](https://es.wikipedia.org/wiki/Dolor_abdominal "Dolor abdominal – Spanish") - [Euskara](https://eu.wikipedia.org/wiki/Tripako_min "Tripako min – Basque") - [فارسی](https://fa.wikipedia.org/wiki/%D8%AF%D8%B1%D8%AF_%D8%B4%DA%A9%D9%85%DB%8C "درد شکمی – Persian") - [Suomi](https://fi.wikipedia.org/wiki/Vatsakipu "Vatsakipu – Finnish") - [Français](https://fr.wikipedia.org/wiki/Douleur_abdominale "Douleur abdominale – French") - [Avañe'ẽ](https://gn.wikipedia.org/wiki/Py%27arasy "Py'arasy – Guarani") - [Hausa](https://ha.wikipedia.org/wiki/Ciwon_ciki "Ciwon ciki – Hausa") - [עברית](https://he.wikipedia.org/wiki/%D7%9B%D7%90%D7%91_%D7%91%D7%98%D7%9F "כאב בטן – Hebrew") - [हिन्दी](https://hi.wikipedia.org/wiki/%E0%A4%AA%E0%A5%87%E0%A4%9F_%E0%A4%A6%E0%A4%B0%E0%A5%8D%E0%A4%A6 "पेट दर्द – Hindi") - [Հայերեն](https://hy.wikipedia.org/wiki/%D5%88%D6%80%D5%B8%D5%BE%D5%A1%D5%B5%D5%B6%D5%A1%D5%B5%D5%AB%D5%B6_%D6%81%D5%A1%D5%BE "Որովայնային ցավ – Armenian") - [Bahasa Indonesia](https://id.wikipedia.org/wiki/Mulas "Mulas – Indonesian") - [Ido](https://io.wikipedia.org/wiki/Gastralgio "Gastralgio – Ido") - [Italiano](https://it.wikipedia.org/wiki/Dolore_addominale "Dolore addominale – Italian") - [日本語](https://ja.wikipedia.org/wiki/%E8%85%B9%E7%97%9B "腹痛 – Japanese") - [한국어](https://ko.wikipedia.org/wiki/%EB%B3%B5%ED%86%B5 "복통 – Korean") - [کٲشُر](https://ks.wikipedia.org/wiki/%DB%8C%DA%88_%D8%AF%D9%8E%DA%AF "یڈ دَگ – Kashmiri") - [Македонски](https://mk.wikipedia.org/wiki/%D0%91%D0%BE%D0%BB%D0%BA%D0%B8_%D0%B2%D0%BE_%D1%81%D1%82%D0%BE%D0%BC%D0%B0%D0%BA%D0%BE%D1%82 "Болки во стомакот – Macedonian") - [मराठी](https://mr.wikipedia.org/wiki/%E0%A4%89%E0%A4%A6%E0%A4%B0%E0%A4%B6%E0%A5%82%E0%A4%B2 "उदरशूल – Marathi") - [Bahasa Melayu](https://ms.wikipedia.org/wiki/Sakit_abdomen "Sakit abdomen – Malay") - [Nederlands](https://nl.wikipedia.org/wiki/Buikpijn "Buikpijn – Dutch") - [ଓଡ଼ିଆ](https://or.wikipedia.org/wiki/%E0%AC%89%E0%AC%A6%E0%AC%B0_%E0%AC%AF%E0%AC%A8%E0%AD%8D%E0%AC%A4%E0%AD%8D%E0%AC%B0%E0%AC%A3%E0%AC%BE "ଉଦର ଯନ୍ତ୍ରଣା – Odia") - [Polski](https://pl.wikipedia.org/wiki/B%C3%B3l_brzucha "Ból brzucha – Polish") - [پښتو](https://ps.wikipedia.org/wiki/%D9%86%D8%B3%D8%AE%D9%88%DA%96%DB%8C "نسخوږی – Pashto") - [Português](https://pt.wikipedia.org/wiki/Dor_abdominal "Dor abdominal – Portuguese") - [Română](https://ro.wikipedia.org/wiki/Durere_abdominal%C4%83 "Durere abdominală – Romanian") - [Русский](https://ru.wikipedia.org/wiki/%D0%91%D0%BE%D0%BB%D0%B8_%D0%B2_%D0%BE%D0%B1%D0%BB%D0%B0%D1%81%D1%82%D0%B8_%D0%B6%D0%B8%D0%B2%D0%BE%D1%82%D0%B0_%D0%B8_%D1%82%D0%B0%D0%B7%D0%B0 "Боли в области живота и таза – Russian") - [سنڌي](https://sd.wikipedia.org/wiki/%D9%BE%D9%8A%D9%BD_%DB%BE_%D8%B3%D9%88%D8%B1 "پيٽ ۾ سور – Sindhi") - [Srpskohrvatski / српскохрватски](https://sh.wikipedia.org/wiki/Bol_u_trbuhu "Bol u trbuhu – Serbo-Croatian") - [Simple English](https://simple.wikipedia.org/wiki/Abdominal_pain "Abdominal pain – Simple English") - [Slovenščina](https://sl.wikipedia.org/wiki/Bole%C4%8Dina_v_trebuhu "Bolečina v trebuhu – Slovenian") - [Српски / srpski](https://sr.wikipedia.org/wiki/%D0%91%D0%BE%D0%BB_%D1%83_%D1%82%D1%80%D0%B1%D1%83%D1%85%D1%83 "Бол у трбуху – Serbian") - [Svenska](https://sv.wikipedia.org/wiki/Magsm%C3%A4rta "Magsmärta – Swedish") - [Kiswahili](https://sw.wikipedia.org/wiki/Maumivu_ya_tumbo "Maumivu ya tumbo – Swahili") - [தமிழ்](https://ta.wikipedia.org/wiki/%E0%AE%B5%E0%AE%AF%E0%AE%BF%E0%AE%B1%E0%AF%8D%E0%AE%B1%E0%AF%81_%E0%AE%B5%E0%AE%B2%E0%AE%BF "வயிற்று வலி – Tamil") - [తెలుగు](https://te.wikipedia.org/wiki/%E0%B0%95%E0%B0%A1%E0%B1%81%E0%B0%AA%E0%B1%81%E0%B0%A8%E0%B1%8A%E0%B0%AA%E0%B1%8D%E0%B0%AA%E0%B0%BF "కడుపునొప్పి – Telugu") - [ไทย](https://th.wikipedia.org/wiki/%E0%B8%9B%E0%B8%A7%E0%B8%94%E0%B8%97%E0%B9%89%E0%B8%AD%E0%B8%87 "ปวดท้อง – Thai") - [Tagalog](https://tl.wikipedia.org/wiki/Pananakit_ng_tiyan "Pananakit ng tiyan – Tagalog") - [Türkçe](https://tr.wikipedia.org/wiki/Kar%C4%B1n_a%C4%9Fr%C4%B1s%C4%B1 "Karın ağrısı – Turkish") - [Татарча / tatarça](https://tt.wikipedia.org/wiki/%D0%AD%D1%87_%D0%B0%D0%B2%D1%8B%D1%80%D1%82%D1%83%D0%BB%D0%B0%D1%80%D1%8B "Эч авыртулары – Tatar") - [Українська](https://uk.wikipedia.org/wiki/%D0%91%D1%96%D0%BB%D1%8C_%D1%83_%D0%B6%D0%B8%D0%B2%D0%BE%D1%82%D1%96 "Біль у животі – Ukrainian") - [Tiếng Việt](https://vi.wikipedia.org/wiki/%C4%90au_b%E1%BB%A5ng "Đau bụng – Vietnamese") - [Vahcuengh](https://za.wikipedia.org/wiki/Lajdungxin "Lajdungxin – Zhuang") - [粵語](https://zh-yue.wikipedia.org/wiki/%E8%82%9A%E7%97%9B "肚痛 – Cantonese") - [中文](https://zh.wikipedia.org/wiki/%E8%85%B9%E7%97%9B "腹痛 – Chinese") [Edit links](https://www.wikidata.org/wiki/Special:EntityPage/Q183425#sitelinks-wikipedia "Edit interlanguage links") - [Article](https://en.wikipedia.org/wiki/Abdominal_pain "View the content page [c]") - [Talk](https://en.wikipedia.org/wiki/Talk:Abdominal_pain "Discuss improvements to the content page [t]") English - [Read](https://en.wikipedia.org/wiki/Abdominal_pain) - [Edit](https://en.wikipedia.org/w/index.php?title=Abdominal_pain&action=edit "Edit this page [e]") - [View history](https://en.wikipedia.org/w/index.php?title=Abdominal_pain&action=history "Past revisions of this page [h]") Tools Tools move to sidebar hide Actions - 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Medical condition \| Abdominal pain \| \| \|---\|---\| \| Other names \| Stomach ache, tummy ache, belly ache, belly pain, gastralgia, stomach pain \| \| [![](https://upload.wikimedia.org/wikipedia/commons/thumb/f/f0/Gray1220.svg/250px-Gray1220.svg.png)](https://en.wikipedia.org/wiki/File:Gray1220.svg) \| \| \| Abdominal pain can be characterized by the region it affects. \| \| \| [Specialty](https://en.wikipedia.org/wiki/Medical_specialty "Medical specialty") \| [Gastroenterology](https://en.wikipedia.org/wiki/Gastroenterology "Gastroenterology"), [general surgery](https://en.wikipedia.org/wiki/General_surgery "General surgery") \| \| [Complications](https://en.wikipedia.org/wiki/Complication_\(medicine\) "Complication (medicine)") \| [Anorexia](https://en.wikipedia.org/wiki/Anorexia_\(symptom\) "Anorexia (symptom)") \| \| [Causes](https://en.wikipedia.org/wiki/Cause_\(medicine\) "Cause (medicine)") \| Serious: [Appendicitis](https://en.wikipedia.org/wiki/Appendicitis "Appendicitis"), perforated [stomach ulcer](https://en.wikipedia.org/wiki/Stomach_ulcer "Stomach ulcer"), [pancreatitis](https://en.wikipedia.org/wiki/Pancreatitis "Pancreatitis"), ruptured [diverticulitis](https://en.wikipedia.org/wiki/Diverticulitis "Diverticulitis"), [ovarian torsion](https://en.wikipedia.org/wiki/Ovarian_torsion "Ovarian torsion"), [volvulus](https://en.wikipedia.org/wiki/Volvulus "Volvulus"), ruptured [aortic aneurysm](https://en.wikipedia.org/wiki/Aortic_aneurysm "Aortic aneurysm"), [lacerated spleen](https://en.wikipedia.org/wiki/Lacerated_spleen "Lacerated spleen") or liver, [ischemic colitis](https://en.wikipedia.org/wiki/Ischemic_colitis "Ischemic colitis"), [ischaemic myocardial conditions](https://en.wikipedia.org/w/index.php?title=Ischaemic_myocardial_conditions&action=edit&redlink=1 "Ischaemic myocardial conditions (page does not exist)")[\[1\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Stat2018-1) Common: [Gastroenteritis](https://en.wikipedia.org/wiki/Gastroenteritis "Gastroenteritis"), [irritable bowel syndrome](https://en.wikipedia.org/wiki/Irritable_bowel_syndrome "Irritable bowel syndrome")[\[2\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Vin2014-2) \| Abdominal pain, also known as a stomach ache, is a [symptom](https://en.wikipedia.org/wiki/Symptom "Symptom") associated with both non-serious and serious medical issues. Since the abdomen contains most of the body's vital organs, it can be an indicator of a wide variety of diseases. Given that, approaching the examination of a person and planning of a [differential diagnosis](https://en.wikipedia.org/wiki/Differential_diagnosis "Differential diagnosis") is extremely important.[\[3\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Hopcroft2020-3) Common causes of [pain](https://en.wikipedia.org/wiki/Pain "Pain") in the [abdomen](https://en.wikipedia.org/wiki/Abdomen "Abdomen") include [gastroenteritis](https://en.wikipedia.org/wiki/Gastroenteritis "Gastroenteritis") and [irritable bowel syndrome](https://en.wikipedia.org/wiki/Irritable_bowel_syndrome "Irritable bowel syndrome").[\[3\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Hopcroft2020-3) About 15% of people have a more serious underlying condition such as [appendicitis](https://en.wikipedia.org/wiki/Appendicitis "Appendicitis"), leaking or ruptured [abdominal aortic aneurysm](https://en.wikipedia.org/wiki/Abdominal_aortic_aneurysm "Abdominal aortic aneurysm"), [diverticulitis](https://en.wikipedia.org/wiki/Diverticulitis "Diverticulitis"), or [ectopic pregnancy](https://en.wikipedia.org/wiki/Ectopic_pregnancy "Ectopic pregnancy").[\[2\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Vin2014-2) In a third of cases, the exact cause is unclear.[\[2\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Vin2014-2) ## Signs and symptoms \[[edit](https://en.wikipedia.org/w/index.php?title=Abdominal_pain&action=edit&section=1 "Edit section: Signs and symptoms")\] The onset of abdominal pain can be abrupt, quick, or gradual. Sudden onset pain happens in a split second. Rapidly onset pain starts mild and gets worse over the next few minutes. Pain that gradually intensifies only after several hours or even days has passed is referred to as gradual onset pain.[\[4\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Sherman_1990_r770-4) One can describe abdominal pain as either continuous or sporadic and as [cramping](https://en.wikipedia.org/wiki/Cramp "Cramp"), dull, or aching. The characteristic of cramping abdominal pain is that it comes in brief waves, builds to a peak, and then abruptly stops for a period during which there is no more pain. The pain flares up and off periodically. The most common cause of persistent dull or aching abdominal pain is edema or distention of the wall of a hollow viscus. A dull or aching pain may also be felt due to a stretch in the liver and spleen capsules.[\[4\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Sherman_1990_r770-4) ## Causes \[[edit](https://en.wikipedia.org/w/index.php?title=Abdominal_pain&action=edit&section=2 "Edit section: Causes")\] The most frequent reasons for abdominal pain are [gastroenteritis](https://en.wikipedia.org/wiki/Gastroenteritis "Gastroenteritis") (13%), [irritable bowel syndrome](https://en.wikipedia.org/wiki/Irritable_bowel_syndrome "Irritable bowel syndrome") (8%), urinary tract problems (5%), [inflammation of the stomach](https://en.wikipedia.org/wiki/Gastritis "Gastritis") (5%) and [constipation](https://en.wikipedia.org/wiki/Constipation "Constipation") (5%). In about 30% of cases, the cause is not determined. About 10% of cases have a more serious cause including gallbladder ([gallstones](https://en.wikipedia.org/wiki/Gallstone "Gallstone") or [biliary dyskinesia](https://en.wikipedia.org/wiki/Biliary_dyskinesia "Biliary dyskinesia")) or [pancreas](https://en.wikipedia.org/wiki/Pancreas "Pancreas") problems (4%), [diverticulitis](https://en.wikipedia.org/wiki/Diverticulitis "Diverticulitis") (3%), [appendicitis](https://en.wikipedia.org/wiki/Appendicitis "Appendicitis") (2%) and [cancer](https://en.wikipedia.org/wiki/Cancer "Cancer") (1%).[\[2\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Vin2014-2) More common in those who are older, [ischemic colitis](https://en.wikipedia.org/wiki/Ischemic_colitis "Ischemic colitis"),[\[5\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-5) [mesenteric ischemia](https://en.wikipedia.org/wiki/Mesenteric_ischemia "Mesenteric ischemia"), and [abdominal aortic aneurysms](https://en.wikipedia.org/wiki/Abdominal_aortic_aneurysm "Abdominal aortic aneurysm") are other serious causes.[\[6\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Spangler_2014-6) ### Acute abdomen \[[edit](https://en.wikipedia.org/w/index.php?title=Abdominal_pain&action=edit&section=3 "Edit section: Acute abdomen")\] [Acute abdomen](https://en.wikipedia.org/wiki/Acute_abdomen "Acute abdomen") is a condition where there is a sudden onset of severe abdominal pain requiring immediate recognition and management of the underlying cause.[\[7\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-aa-7) The underlying cause may involve infection, [inflammation](https://en.wikipedia.org/wiki/Inflammation "Inflammation"), [vascular occlusion](https://en.wikipedia.org/wiki/Vascular_occlusion "Vascular occlusion") or bowel obstruction.[\[7\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-aa-7) The pain may elicit [nausea](https://en.wikipedia.org/wiki/Nausea "Nausea") and [vomiting](https://en.wikipedia.org/wiki/Vomiting "Vomiting"), [abdominal distention](https://en.wikipedia.org/wiki/Abdominal_distention "Abdominal distention"), [fever](https://en.wikipedia.org/wiki/Fever "Fever") and signs of [shock](https://en.wikipedia.org/wiki/Shock_\(circulatory\) "Shock (circulatory)").[\[7\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-aa-7) A common condition associated with acute abdominal pain is [appendicitis](https://en.wikipedia.org/wiki/Appendicitis "Appendicitis").[\[8\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-8) Here is a list of acute abdomen causes: \| \| \| \|---\|---\| \| Surgical causes \[[edit](https://en.wikipedia.org/w/index.php?title=Abdominal_pain&action=edit&section=4 "Edit section: Surgical causes")\] \| Source:[\[7\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-aa-7) Inflammatory \[[edit](https://en.wikipedia.org/w/index.php?title=Abdominal_pain&action=edit&section=5 "Edit section: Inflammatory")\] Infections such as [appendicitis](https://en.wikipedia.org/wiki/Appendicitis "Appendicitis"), [cholecystitis](https://en.wikipedia.org/wiki/Cholecystitis "Cholecystitis"), [pancreatitis](https://en.wikipedia.org/wiki/Pancreatitis "Pancreatitis"), [pyelonephritis](https://en.wikipedia.org/wiki/Pyelonephritis "Pyelonephritis"), [Peritonitis](https://en.wikipedia.org/wiki/Peritonitis "Peritonitis"), [pelvic inflammatory disease](https://en.wikipedia.org/wiki/Pelvic_inflammatory_disease "Pelvic inflammatory disease"), [hepatitis](https://en.wikipedia.org/wiki/Hepatitis "Hepatitis"), [mesenteric adenitis](https://en.wikipedia.org/wiki/Mesenteric_adenitis "Mesenteric adenitis"), or a subdiaphragmatic [abscess](https://en.wikipedia.org/wiki/Abscess "Abscess"). [Perforation](https://en.wikipedia.org/wiki/Gastrointestinal_perforation "Gastrointestinal perforation") of a [peptic ulcer](https://en.wikipedia.org/wiki/Peptic_ulcer "Peptic ulcer"), a [diverticulum](https://en.wikipedia.org/wiki/Diverticulitis "Diverticulitis"), or the [caecum](https://en.wikipedia.org/wiki/Caecum "Caecum"). Complications of [inflammatory bowel disease](https://en.wikipedia.org/wiki/Inflammatory_bowel_disease "Inflammatory bowel disease"), such as [Crohn's disease](https://en.wikipedia.org/wiki/Crohn%27s_disease "Crohn's disease") or [ulcerative colitis](https://en.wikipedia.org/wiki/Ulcerative_colitis "Ulcerative colitis"). Mechanical \[[edit](https://en.wikipedia.org/w/index.php?title=Abdominal_pain&action=edit&section=6 "Edit section: Mechanical")\] [Small bowel](https://en.wikipedia.org/wiki/Small_bowel "Small bowel") [obstruction](https://en.wikipedia.org/wiki/Bowel_obstruction "Bowel obstruction") secondary to adhesions caused by previous surgeries, [intussusception](https://en.wikipedia.org/wiki/Intussusception_\(medical_disorder\) "Intussusception (medical disorder)"), [hernias](https://en.wikipedia.org/wiki/Hernia "Hernia"), benign or malignant [neoplasms](https://en.wikipedia.org/wiki/Neoplasia "Neoplasia"). [Large bowel](https://en.wikipedia.org/wiki/Large_bowel "Large bowel") [obstruction](https://en.wikipedia.org/wiki/Bowel_obstruction "Bowel obstruction") caused by [colorectal cancer](https://en.wikipedia.org/wiki/Colorectal_cancer "Colorectal cancer"), [inflammatory bowel disease](https://en.wikipedia.org/wiki/Inflammatory_bowel_disease "Inflammatory bowel disease"), [volvulus](https://en.wikipedia.org/wiki/Volvulus "Volvulus"), [fecal impaction](https://en.wikipedia.org/wiki/Fecal_impaction "Fecal impaction"), or [hernia](https://en.wikipedia.org/wiki/Hernia "Hernia"). Vascular \[[edit](https://en.wikipedia.org/w/index.php?title=Abdominal_pain&action=edit&section=7 "Edit section: Vascular")\] occlusive [intestinal ischemia](https://en.wikipedia.org/wiki/Intestinal_ischemia "Intestinal ischemia"), usually caused by [thromboembolism](https://en.wikipedia.org/wiki/Thromboembolism "Thromboembolism") of the [superior Mesenteric artery.](https://en.wikipedia.org/wiki/Superior_mesenteric_artery "Superior mesenteric artery") [Referred pain](https://en.wikipedia.org/wiki/Referred_pain "Referred pain") \[[edit](https://en.wikipedia.org/w/index.php?title=Abdominal_pain&action=edit&section=8 "Edit section: Referred pain")\] Source:[\[9\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-9) Viscero-visceral referral: happens when one organ with afferent nerves close to another organ is sensitized or inflamed (in this case any of the abdominal viscera)[\[10\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-10) Viscero-somatic referral: any pain in the viscera that causes pain in the muscle, bone, and skin (of the abdomen in case of abdominal pain) Somatic-visceral referral: pain in the skin, muscles, and bone that causes referred pain in the viscera (of the abdomen such as the stomach, kidneys, bladder, etc.) \| \| Medical causes \[[edit](https://en.wikipedia.org/w/index.php?title=Abdominal_pain&action=edit&section=9 "Edit section: Medical causes")\] \| Source:[\[7\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-aa-7)[Acute pancreatitis](https://en.wikipedia.org/wiki/Acute_pancreatitis "Acute pancreatitis").[Sickle cell anemia](https://en.wikipedia.org/wiki/Sickle_cell_disease "Sickle cell disease").[Diabetic ketoacidosis](https://en.wikipedia.org/wiki/Diabetic_ketoacidosis "Diabetic ketoacidosis") (DKA).[Adrenal crisis](https://en.wikipedia.org/wiki/Adrenal_crisis "Adrenal crisis").[Pyelonephritis](https://en.wikipedia.org/wiki/Pyelonephritis "Pyelonephritis").[Lead poisoning](https://en.wikipedia.org/wiki/Lead_poisoning "Lead poisoning").[Familial Mediterranean fever](https://en.wikipedia.org/wiki/Familial_Mediterranean_fever "Familial Mediterranean fever") (FMF). \| \| Gynecological causes \[[edit](https://en.wikipedia.org/w/index.php?title=Abdominal_pain&action=edit&section=10 "Edit section: Gynecological causes")\] \| Source:[\[11\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-11)[Pelvic inflammatory disease](https://en.wikipedia.org/wiki/Pelvic_inflammatory_disease "Pelvic inflammatory disease") (PID) and abscess.[Ectopic pregnancy](https://en.wikipedia.org/wiki/Ectopic_pregnancy "Ectopic pregnancy").Hemorrhagic [ovarian cyst](https://en.wikipedia.org/wiki/Ovarian_cyst "Ovarian cyst").Adnexal or [ovarian torsion](https://en.wikipedia.org/wiki/Ovarian_torsion "Ovarian torsion"). \| ### By system \[[edit](https://en.wikipedia.org/w/index.php?title=Abdominal_pain&action=edit&section=11 "Edit section: By system")\] A more extensive list includes the following:\[[citation needed](https://en.wikipedia.org/wiki/Wikipedia:Citation_needed "Wikipedia:Citation needed")\] - Gastrointestinal - GI tract - Inflammatory: [gastroenteritis](https://en.wikipedia.org/wiki/Gastroenteritis "Gastroenteritis"), [appendicitis](https://en.wikipedia.org/wiki/Appendicitis "Appendicitis"), [gastritis](https://en.wikipedia.org/wiki/Gastritis "Gastritis"), [esophagitis](https://en.wikipedia.org/wiki/Esophagitis "Esophagitis"), [diverticulitis](https://en.wikipedia.org/wiki/Diverticulitis "Diverticulitis"), [Crohn's disease](https://en.wikipedia.org/wiki/Crohn%27s_disease "Crohn's disease"), [ulcerative colitis](https://en.wikipedia.org/wiki/Ulcerative_colitis "Ulcerative colitis"), [microscopic colitis](https://en.wikipedia.org/wiki/Microscopic_colitis "Microscopic colitis") - Obstruction: [hernia](https://en.wikipedia.org/wiki/Hernia "Hernia"), [intussusception](https://en.wikipedia.org/wiki/Intussusception_\(medical_disorder\) "Intussusception (medical disorder)"), [volvulus](https://en.wikipedia.org/wiki/Volvulus "Volvulus"), post-surgical [adhesions](https://en.wikipedia.org/wiki/Adhesions "Adhesions"), [tumors](https://en.wikipedia.org/wiki/Tumor "Tumor"), severe [constipation](https://en.wikipedia.org/wiki/Constipation "Constipation"), [hemorrhoids](https://en.wikipedia.org/wiki/Hemorrhoids "Hemorrhoids") - Vascular: [embolism](https://en.wikipedia.org/wiki/Embolism "Embolism"), [thrombosis](https://en.wikipedia.org/wiki/Thrombosis "Thrombosis"), [hemorrhage](https://en.wikipedia.org/wiki/Hemorrhage "Hemorrhage"), [sickle cell disease](https://en.wikipedia.org/wiki/Sickle_cell_disease "Sickle cell disease"), [abdominal angina](https://en.wikipedia.org/wiki/Abdominal_angina "Abdominal angina"), blood vessel compression (such as celiac artery compression syndrome), [superior mesenteric artery syndrome](https://en.wikipedia.org/wiki/Superior_mesenteric_artery_syndrome "Superior mesenteric artery syndrome"), [postural orthostatic tachycardia syndrome](https://en.wikipedia.org/wiki/Postural_orthostatic_tachycardia_syndrome "Postural orthostatic tachycardia syndrome") - [Digestive](https://en.wikipedia.org/wiki/Digestion "Digestion"): [peptic ulcer](https://en.wikipedia.org/wiki/Peptic_ulcer "Peptic ulcer"), [lactose intolerance](https://en.wikipedia.org/wiki/Lactose_intolerance "Lactose intolerance"), [celiac disease](https://en.wikipedia.org/wiki/Coeliac_disease "Coeliac disease"), [food allergies](https://en.wikipedia.org/wiki/Food_allergies "Food allergies"), [indigestion](https://en.wikipedia.org/wiki/Indigestion "Indigestion") - Glands - Bile system - Inflammatory: [cholecystitis](https://en.wikipedia.org/wiki/Cholecystitis "Cholecystitis"), [cholangitis](https://en.wikipedia.org/wiki/Cholangitis "Cholangitis") - Obstruction: [cholelithiasis](https://en.wikipedia.org/wiki/Cholelithiasis "Cholelithiasis") - Liver - Inflammatory: [hepatitis](https://en.wikipedia.org/wiki/Hepatitis "Hepatitis"), [liver abscess](https://en.wikipedia.org/wiki/Liver_abscess "Liver abscess") - Pancreatic - Inflammatory: [pancreatitis](https://en.wikipedia.org/wiki/Pancreatitis "Pancreatitis") - Renal and urological - Inflammation: [pyelonephritis](https://en.wikipedia.org/wiki/Pyelonephritis "Pyelonephritis"), [bladder infection](https://en.wikipedia.org/wiki/Cystitis "Cystitis") - Obstruction: [kidney stones](https://en.wikipedia.org/wiki/Nephrolithiasis "Nephrolithiasis"), [urolithiasis](https://en.wikipedia.org/wiki/Urolithiasis "Urolithiasis"), [urinary retention](https://en.wikipedia.org/wiki/Urinary_retention "Urinary retention") - Vascular: [left renal vein entrapment](https://en.wikipedia.org/wiki/Left_renal_vein_entrapment "Left renal vein entrapment") - Gynaecological or obstetric - Inflammatory: [pelvic inflammatory disease](https://en.wikipedia.org/wiki/Pelvic_inflammatory_disease "Pelvic inflammatory disease") - Mechanical: [ovarian torsion](https://en.wikipedia.org/wiki/Ovarian_torsion "Ovarian torsion") - Endocrinological: [menstruation](https://en.wikipedia.org/wiki/Menstruation "Menstruation"), [Mittelschmerz](https://en.wikipedia.org/wiki/Mittelschmerz "Mittelschmerz") - Tumors: [endometriosis](https://en.wikipedia.org/wiki/Endometriosis "Endometriosis"), [fibroids](https://en.wikipedia.org/wiki/Fibroma "Fibroma"), [ovarian cyst](https://en.wikipedia.org/wiki/Ovarian_cyst "Ovarian cyst"), [ovarian cancer](https://en.wikipedia.org/wiki/Ovarian_cancer "Ovarian cancer") - Pregnancy: ruptured [ectopic pregnancy](https://en.wikipedia.org/wiki/Ectopic_pregnancy "Ectopic pregnancy"), [threatened abortion](https://en.wikipedia.org/wiki/Threatened_abortion "Threatened abortion") - [Abdominal wall](https://en.wikipedia.org/wiki/Abdominal_wall "Abdominal wall") - muscle strain or trauma - muscular infection - [neurogenic](https://en.wikipedia.org/wiki/Neurogenic "Neurogenic") pain: [herpes zoster](https://en.wikipedia.org/wiki/Herpes_zoster "Herpes zoster"), [radiculitis](https://en.wikipedia.org/wiki/Radiculitis "Radiculitis") in [Lyme disease](https://en.wikipedia.org/wiki/Lyme_disease "Lyme disease"), [abdominal cutaneous nerve entrapment syndrome](https://en.wikipedia.org/wiki/Anterior_cutaneous_nerve_entrapment_syndrome "Anterior cutaneous nerve entrapment syndrome") (ACNES), [tabes dorsalis](https://en.wikipedia.org/wiki/Tabes_dorsalis "Tabes dorsalis") - [Referred pain](https://en.wikipedia.org/wiki/Referred_pain "Referred pain") - from the [thorax](https://en.wikipedia.org/wiki/Thorax "Thorax"): [pneumonia](https://en.wikipedia.org/wiki/Pneumonia "Pneumonia"), [pulmonary embolism](https://en.wikipedia.org/wiki/Pulmonary_embolism "Pulmonary embolism"), [ischemic heart disease](https://en.wikipedia.org/wiki/Ischemic_heart_disease "Ischemic heart disease"), [pericarditis](https://en.wikipedia.org/wiki/Pericarditis "Pericarditis") - from the [spine](https://en.wikipedia.org/wiki/Vertebral_column "Vertebral column"): [radiculitis](https://en.wikipedia.org/wiki/Radiculitis "Radiculitis") - from the [genitals](https://en.wikipedia.org/wiki/Genitals "Genitals"): [testicular torsion](https://en.wikipedia.org/wiki/Testicular_torsion "Testicular torsion") - [Metabolic disturbance](https://en.wikipedia.org/wiki/Metabolic_disturbance "Metabolic disturbance") - [uremia](https://en.wikipedia.org/wiki/Uremia "Uremia"), [diabetic ketoacidosis](https://en.wikipedia.org/wiki/Diabetic_ketoacidosis "Diabetic ketoacidosis"), [porphyria](https://en.wikipedia.org/wiki/Porphyria "Porphyria"), [C1-esterase inhibitor deficiency](https://en.wikipedia.org/wiki/C1-esterase_inhibitor_deficiency "C1-esterase inhibitor deficiency"), adrenal insufficiency, [lead poisoning](https://en.wikipedia.org/wiki/Lead_poisoning "Lead poisoning"), [black widow spider](https://en.wikipedia.org/wiki/Latrodectus "Latrodectus") bite, [narcotic](https://en.wikipedia.org/wiki/Narcotic "Narcotic") [withdrawal](https://en.wikipedia.org/wiki/Drug_withdrawal "Drug withdrawal") - Blood vessels - [aortic dissection](https://en.wikipedia.org/wiki/Aortic_dissection "Aortic dissection"), [abdominal aortic aneurysm](https://en.wikipedia.org/wiki/Abdominal_aortic_aneurysm "Abdominal aortic aneurysm") - Immune system - [sarcoidosis](https://en.wikipedia.org/wiki/Sarcoidosis "Sarcoidosis") - [vasculitis](https://en.wikipedia.org/wiki/Vasculitis "Vasculitis") - [familial Mediterranean fever](https://en.wikipedia.org/wiki/Familial_Mediterranean_fever "Familial Mediterranean fever") - Idiopathic - [irritable bowel syndrome](https://en.wikipedia.org/wiki/Irritable_bowel_syndrome "Irritable bowel syndrome") (IBS) (affecting up to 20% of the population, IBS is the most common cause of recurrent and intermittent abdominal pain) ### By location \[[edit](https://en.wikipedia.org/w/index.php?title=Abdominal_pain&action=edit&section=12 "Edit section: By location")\] The location of abdominal pain can provide information about what may be causing the pain. The abdomen can be divided into four regions called quadrants. Locations and associated conditions include:[\[12\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-12)[\[13\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-13) - Diffuse - [Peritonitis](https://en.wikipedia.org/wiki/Peritonitis "Peritonitis") - Vascular: [mesenteric ischemia](https://en.wikipedia.org/wiki/Mesenteric_ischemia "Mesenteric ischemia"), [ischemic colitis](https://en.wikipedia.org/wiki/Ischemic_colitis "Ischemic colitis"), [Henoch-Schonlein purpura](https://en.wikipedia.org/wiki/Henoch%E2%80%93Sch%C3%B6nlein_purpura "Henoch–Schönlein purpura"), [sickle cell disease](https://en.wikipedia.org/wiki/Sickle_cell_disease "Sickle cell disease"), [systemic lupus erythematosus](https://en.wikipedia.org/wiki/Systemic_lupus_erythematosus "Systemic lupus erythematosus"), [polyarteritis nodosa](https://en.wikipedia.org/wiki/Polyarteritis_nodosa "Polyarteritis nodosa") - Small [bowel obstruction](https://en.wikipedia.org/wiki/Bowel_obstruction "Bowel obstruction") - [Irritable bowel syndrome](https://en.wikipedia.org/wiki/Irritable_bowel_syndrome "Irritable bowel syndrome") - [Metabolic disorders](https://en.wikipedia.org/wiki/Metabolic_disorder "Metabolic disorder"): [ketoacidosis](https://en.wikipedia.org/wiki/Ketoacidosis "Ketoacidosis"), [porphyria](https://en.wikipedia.org/wiki/Porphyria "Porphyria"), [familial Mediterranean fever](https://en.wikipedia.org/wiki/Familial_Mediterranean_fever "Familial Mediterranean fever"), [adrenal crisis](https://en.wikipedia.org/wiki/Adrenal_crisis "Adrenal crisis") - Epigastric - Heart: [myocardial infarction](https://en.wikipedia.org/wiki/Myocardial_infarction "Myocardial infarction"), [pericarditis](https://en.wikipedia.org/wiki/Pericarditis "Pericarditis") - Stomach: [gastritis](https://en.wikipedia.org/wiki/Gastritis "Gastritis"), [stomach ulcer](https://en.wikipedia.org/wiki/Stomach_ulcer "Stomach ulcer"), [stomach cancer](https://en.wikipedia.org/wiki/Stomach_cancer "Stomach cancer") - Pancreas: [pancreatitis](https://en.wikipedia.org/wiki/Pancreatitis "Pancreatitis"), [pancreatic cancer](https://en.wikipedia.org/wiki/Pancreatic_cancer "Pancreatic cancer") - Intestinal: [duodenal ulcer](https://en.wikipedia.org/wiki/Peptic_ulcer_disease "Peptic ulcer disease"), [diverticulitis](https://en.wikipedia.org/wiki/Diverticulitis "Diverticulitis"), [appendicitis](https://en.wikipedia.org/wiki/Appendicitis "Appendicitis") - Right upper quadrant - Liver: [hepatomegaly](https://en.wikipedia.org/wiki/Hepatomegaly "Hepatomegaly"), [fatty liver](https://en.wikipedia.org/wiki/Fatty_liver "Fatty liver"), [hepatitis](https://en.wikipedia.org/wiki/Hepatitis "Hepatitis"), [liver cancer](https://en.wikipedia.org/wiki/Liver_cancer "Liver cancer"), [abscess](https://en.wikipedia.org/wiki/Abscess "Abscess") - Gallbladder and biliary tract: [inflammation](https://en.wikipedia.org/wiki/Cholecystitis "Cholecystitis"), [gallstones](https://en.wikipedia.org/wiki/Gallstone "Gallstone"), [worm infection](https://en.wikipedia.org/wiki/Helminthiasis "Helminthiasis"), [cholangitis](https://en.wikipedia.org/wiki/Cholangitis "Cholangitis") - Colon: [bowel obstruction](https://en.wikipedia.org/wiki/Bowel_obstruction "Bowel obstruction"), functional disorders, [gas accumulation](https://en.wikipedia.org/wiki/Bloating "Bloating"), [spasm](https://en.wikipedia.org/wiki/Spasm "Spasm"), inflammation, [colon cancer](https://en.wikipedia.org/wiki/Colon_cancer "Colon cancer") - Other: [pneumonia](https://en.wikipedia.org/wiki/Pneumonia "Pneumonia"), [Fitz-Hugh-Curtis syndrome](https://en.wikipedia.org/wiki/Fitz-Hugh%E2%80%93Curtis_syndrome "Fitz-Hugh–Curtis syndrome") - Left upper quadrant - [Splenomegaly](https://en.wikipedia.org/wiki/Splenomegaly "Splenomegaly") - Colon: [bowel obstruction](https://en.wikipedia.org/wiki/Bowel_obstruction "Bowel obstruction"), functional disorders, gas accumulation, spasm, inflammation, colon cancer - Peri-umbilical (the area around the umbilicus, i.e., the belly button) - [Appendicitis](https://en.wikipedia.org/wiki/Appendicitis "Appendicitis") - [Pancreatitis](https://en.wikipedia.org/wiki/Pancreatitis "Pancreatitis") - [Inferior myocardial infarction](https://en.wikipedia.org/wiki/Myocardial_infarction "Myocardial infarction") - [Peptic ulcer](https://en.wikipedia.org/wiki/Peptic_ulcer_disease "Peptic ulcer disease") - [Diabetic ketoacidosis](https://en.wikipedia.org/wiki/Diabetic_ketoacidosis "Diabetic ketoacidosis") - Vascular: [aortic dissection](https://en.wikipedia.org/wiki/Aortic_dissection "Aortic dissection"), aortic rupture - Bowel: [mesenteric ischemia](https://en.wikipedia.org/wiki/Mesenteric_ischemia "Mesenteric ischemia"), [Celiac disease](https://en.wikipedia.org/wiki/Coeliac_disease "Coeliac disease"), inflammation, intestinal spasm, functional disorders, [small bowel obstruction](https://en.wikipedia.org/wiki/Bowel_obstruction "Bowel obstruction") - Lower abdominal pain - [Diarrhea](https://en.wikipedia.org/wiki/Diarrhea "Diarrhea") - [Colitis](https://en.wikipedia.org/wiki/Colitis "Colitis") - [Crohn's](https://en.wikipedia.org/wiki/Crohn%27s_disease "Crohn's disease") - [Dysentery](https://en.wikipedia.org/wiki/Dysentery "Dysentery") - [Hernia](https://en.wikipedia.org/wiki/Hernia "Hernia") - Right lower quadrant - Colon: [intussusception](https://en.wikipedia.org/wiki/Intussusception_\(medical_disorder\) "Intussusception (medical disorder)"), [bowel obstruction](https://en.wikipedia.org/wiki/Bowel_obstruction "Bowel obstruction"), [appendicitis](https://en.wikipedia.org/wiki/Appendicitis "Appendicitis") ([McBurney's point](https://en.wikipedia.org/wiki/McBurney%27s_point "McBurney's point")) - Renal: [kidney stone](https://en.wikipedia.org/wiki/Kidney_stone_disease "Kidney stone disease") (nephrolithiasis), [pyelonephritis](https://en.wikipedia.org/wiki/Pyelonephritis "Pyelonephritis") - Pelvic: [cystitis](https://en.wikipedia.org/wiki/Cystitis "Cystitis"), [bladder stone](https://en.wikipedia.org/wiki/Bladder_stone "Bladder stone"), [bladder cancer](https://en.wikipedia.org/wiki/Bladder_cancer "Bladder cancer"), [pelvic inflammatory disease](https://en.wikipedia.org/wiki/Pelvic_inflammatory_disease "Pelvic inflammatory disease"), pelvic pain syndrome - Gynecologic: [endometriosis](https://en.wikipedia.org/wiki/Endometriosis "Endometriosis"), intrauterine [pregnancy](https://en.wikipedia.org/wiki/Pregnancy "Pregnancy"), [ectopic pregnancy](https://en.wikipedia.org/wiki/Ectopic_pregnancy "Ectopic pregnancy"), [ovarian cyst](https://en.wikipedia.org/wiki/Ovarian_cyst "Ovarian cyst"), [ovarian torsion](https://en.wikipedia.org/wiki/Ovarian_torsion "Ovarian torsion"), fibroid ([leiomyoma](https://en.wikipedia.org/wiki/Leiomyoma "Leiomyoma")), [abscess](https://en.wikipedia.org/wiki/Abscess "Abscess"), [ovarian cancer](https://en.wikipedia.org/wiki/Ovarian_cancer "Ovarian cancer"), [endometrial cancer](https://en.wikipedia.org/wiki/Endometrial_cancer "Endometrial cancer") - Left lower quadrant - Bowel: [diverticulitis](https://en.wikipedia.org/wiki/Diverticulitis "Diverticulitis"), [sigmoid colon volvulus](https://en.wikipedia.org/wiki/Sigmoid_colon_volvulus "Sigmoid colon volvulus"), [bowel obstruction](https://en.wikipedia.org/wiki/Bowel_obstruction "Bowel obstruction"), gas accumulation, [Toxic megacolon](https://en.wikipedia.org/wiki/Toxic_megacolon "Toxic megacolon") - Right [low back pain](https://en.wikipedia.org/wiki/Low_back_pain "Low back pain") - Liver: [hepatomegaly](https://en.wikipedia.org/wiki/Hepatomegaly "Hepatomegaly") - Kidney: [kidney stone](https://en.wikipedia.org/wiki/Kidney_stone_disease "Kidney stone disease") (nephrolithiasis), complicated urinary tract infection - Left low back pain - Spleen - Kidney: [kidney stone](https://en.wikipedia.org/wiki/Kidney_stone_disease "Kidney stone disease") (nephrolithiasis), complicated urinary tract infection - Low back pain - Kidney pain ([kidney stone](https://en.wikipedia.org/wiki/Kidney_stone "Kidney stone"), [kidney cancer](https://en.wikipedia.org/wiki/Kidney_cancer "Kidney cancer"), [hydronephrosis](https://en.wikipedia.org/wiki/Hydronephrosis "Hydronephrosis")) - [Ureteral stone](https://en.wikipedia.org/wiki/Ureter#Ureteral_stones "Ureter") pain ## Mechanism \[[edit](https://en.wikipedia.org/w/index.php?title=Abdominal_pain&action=edit&section=13 "Edit section: Mechanism")\] \| Region \| Blood supply[\[14\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Moore_2016-14) \| Innervation[\[15\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-15) \| Structures[\[14\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Moore_2016-14) \| \|---\|---\|---\|---\| \| [Foregut](https://en.wikipedia.org/wiki/Foregut "Foregut") \| [Celiac artery](https://en.wikipedia.org/wiki/Celiac_artery "Celiac artery") \| T5 - T9 \| [Pharynx](https://en.wikipedia.org/wiki/Pharynx "Pharynx") [Esophagus](https://en.wikipedia.org/wiki/Esophagus "Esophagus")[Lower respiratory tract](https://en.wikipedia.org/wiki/Respiratory_tract "Respiratory tract")[Stomach](https://en.wikipedia.org/wiki/Stomach "Stomach")Proximal [duodenum](https://en.wikipedia.org/wiki/Duodenum "Duodenum")[Liver](https://en.wikipedia.org/wiki/Liver "Liver")[Biliary tract](https://en.wikipedia.org/wiki/Biliary_tract "Biliary tract")[Gallbladder](https://en.wikipedia.org/wiki/Gallbladder "Gallbladder")[Pancreas](https://en.wikipedia.org/wiki/Pancreas "Pancreas") \| \| [Midgut](https://en.wikipedia.org/wiki/Midgut "Midgut") \| [Superior mesenteric artery](https://en.wikipedia.org/wiki/Superior_mesenteric_artery "Superior mesenteric artery") \| T10 – T12 \| Distal [duodenum](https://en.wikipedia.org/wiki/Duodenum "Duodenum") [Cecum](https://en.wikipedia.org/wiki/Cecum "Cecum")[Appendix](https://en.wikipedia.org/wiki/Appendix_\(anatomy\) "Appendix (anatomy)")[Ascending colon](https://en.wikipedia.org/wiki/Ascending_colon "Ascending colon")Proximal [transverse colon](https://en.wikipedia.org/wiki/Transverse_colon "Transverse colon") \| \| [Hindgut](https://en.wikipedia.org/wiki/Hindgut "Hindgut") \| [Inferior mesenteric artery](https://en.wikipedia.org/wiki/Inferior_mesenteric_artery "Inferior mesenteric artery") \| L1 – L3 \| Distal [transverse colon](https://en.wikipedia.org/wiki/Transverse_colon "Transverse colon") [Descending colon](https://en.wikipedia.org/wiki/Descending_colon "Descending colon")[Sigmoid colon](https://en.wikipedia.org/wiki/Sigmoid_colon "Sigmoid colon")[Rectum](https://en.wikipedia.org/wiki/Rectum "Rectum")Superior [anal canal](https://en.wikipedia.org/wiki/Anal_canal "Anal canal") \| Abdominal pain can be referred to as [visceral pain](https://en.wikipedia.org/wiki/Visceral_pain "Visceral pain") or [peritoneal](https://en.wikipedia.org/wiki/Peritoneum "Peritoneum") pain. The contents of the abdomen can be divided into the [foregut](https://en.wikipedia.org/wiki/Foregut "Foregut"), [midgut](https://en.wikipedia.org/wiki/Midgut "Midgut"), and [hindgut](https://en.wikipedia.org/wiki/Hindgut "Hindgut").[\[14\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Moore_2016-14) The [foregut](https://en.wikipedia.org/wiki/Foregut "Foregut") contains the [pharynx](https://en.wikipedia.org/wiki/Pharynx "Pharynx"), lower [respiratory tract](https://en.wikipedia.org/wiki/Respiratory_tract "Respiratory tract"), portions of the [esophagus](https://en.wikipedia.org/wiki/Esophagus "Esophagus"), [stomach](https://en.wikipedia.org/wiki/Stomach "Stomach"), portions of the [duodenum](https://en.wikipedia.org/wiki/Duodenum "Duodenum") (proximal), [liver](https://en.wikipedia.org/wiki/Liver "Liver"), [biliary tract](https://en.wikipedia.org/wiki/Biliary_tract "Biliary tract") (including the [gallbladder](https://en.wikipedia.org/wiki/Gallbladder "Gallbladder") and [bile ducts](https://en.wikipedia.org/wiki/Bile_duct "Bile duct")), and the [pancreas](https://en.wikipedia.org/wiki/Pancreas "Pancreas").[\[14\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Moore_2016-14) The midgut contains portions of the [duodenum](https://en.wikipedia.org/wiki/Duodenum "Duodenum") (distal), [cecum](https://en.wikipedia.org/wiki/Cecum "Cecum"), [appendix](https://en.wikipedia.org/wiki/Appendix_\(anatomy\) "Appendix (anatomy)"), [ascending colon](https://en.wikipedia.org/wiki/Ascending_colon "Ascending colon"), and first half of the [transverse colon](https://en.wikipedia.org/wiki/Transverse_colon "Transverse colon").[\[14\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Moore_2016-14) The hindgut contains the distal half of the transverse colon, [descending colon](https://en.wikipedia.org/wiki/Descending_colon "Descending colon"), [sigmoid colon](https://en.wikipedia.org/wiki/Sigmoid_colon "Sigmoid colon"), [rectum](https://en.wikipedia.org/wiki/Rectum "Rectum"), and superior [anal canal](https://en.wikipedia.org/wiki/Anal_canal "Anal canal").[\[14\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Moore_2016-14) Each subsection of the gut has an associated visceral afferent nerve that transmits sensory information from the viscera to the spinal cord.[\[16\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-16) The visceral sensory information from the gut traveling to the spinal cord, termed the visceral afferent, is non-specific and overlaps with the somatic afferent nerves, which are very specific.[\[17\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Neumayer_2013-17) Therefore, visceral afferent information traveling to the spinal cord can present in the distribution of the somatic afferent nerve; this is why [appendicitis](https://en.wikipedia.org/wiki/Appendicitis "Appendicitis") initially presents with T10 periumbilical pain when it first begins and becomes T12 pain as the abdominal wall peritoneum (which is rich with somatic afferent nerves) is involved.[\[17\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Neumayer_2013-17) ## Diagnosis \[[edit](https://en.wikipedia.org/w/index.php?title=Abdominal_pain&action=edit&section=14 "Edit section: Diagnosis")\] A thorough patient history and physical examination is used to better understand the underlying cause of abdominal pain. The process of gathering a history may include:[\[18\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Bickley_2016-18) - Identifying more information about the [chief complaint](https://en.wikipedia.org/wiki/Presenting_problem "Presenting problem") by eliciting a [history of present illness](https://en.wikipedia.org/wiki/History_of_the_present_illness "History of the present illness"); i.e. a narrative of the current symptoms such as the onset, location, duration, character, aggravating or relieving factors, and temporal nature of the pain. Identifying other possible factors may aid in the diagnosis of the underlying cause of abdominal pain, such as recent travel, recent contact with other ill individuals, and for females, a thorough [gynecologic](https://en.wikipedia.org/wiki/Gynaecology "Gynaecology") history. - Learning about the patient's past medical history, focusing on any prior issues or surgical procedures. - Clarifying the patient's current medication regimen, including prescriptions, over-the-counter medications, and supplements. - Confirming the patient's drug and food allergies. - Discussing with the patient any family history of disease processes, focusing on conditions that might resemble the patient's current presentation. - Discussing with the patient any health-related behaviors (e.g. tobacco use, alcohol consumption, drug use, and sexual activity) that might make certain diagnoses more likely. - Reviewing the presence of non-abdominal symptoms (e.g., [fever](https://en.wikipedia.org/wiki/Fever "Fever"), chills, [chest pain](https://en.wikipedia.org/wiki/Chest_pain "Chest pain"), [shortness of breath](https://en.wikipedia.org/wiki/Shortness_of_breath "Shortness of breath"), [vaginal bleeding](https://en.wikipedia.org/wiki/Vaginal_bleeding "Vaginal bleeding")) that can further clarify the diagnostic picture. - Using [Carnett's sign](https://en.wikipedia.org/wiki/Carnett%27s_sign "Carnett's sign") to differentiate between [visceral pain](https://en.wikipedia.org/wiki/Visceral_pain "Visceral pain") and pain originating in the muscles of the abdominal wall.[\[19\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-19) After gathering a thorough history, one should perform a [physical exam](https://en.wikipedia.org/wiki/Physical_examination "Physical examination") in order to identify important physical signs that might clarify the diagnosis, including a [cardiovascular exam](https://en.wikipedia.org/wiki/Cardiovascular_examination "Cardiovascular examination"), lung exam, thorough abdominal exam, and for females, a [genitourinary](https://en.wikipedia.org/wiki/Genitourinary_system "Genitourinary system") exam.[\[18\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Bickley_2016-18) Additional investigations that can aid diagnosis include:[\[20\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Cartwright_2008-20) - Blood tests including [complete blood count](https://en.wikipedia.org/wiki/Complete_blood_count "Complete blood count"), [basic metabolic panel](https://en.wikipedia.org/wiki/Basic_metabolic_panel "Basic metabolic panel"), [electrolytes](https://en.wikipedia.org/wiki/Electrolyte "Electrolyte"), [liver function tests](https://en.wikipedia.org/wiki/Liver_function_tests "Liver function tests"), [amylase](https://en.wikipedia.org/wiki/Amylase "Amylase"), [lipase](https://en.wikipedia.org/wiki/Lipase "Lipase"), [troponin I](https://en.wikipedia.org/wiki/Troponin_I "Troponin I"), and for females, a serum [pregnancy test](https://en.wikipedia.org/wiki/Pregnancy_test "Pregnancy test"). - [Urinalysis](https://en.wikipedia.org/wiki/Urinalysis "Urinalysis") - Imaging including chest and abdominal [X-rays](https://en.wikipedia.org/wiki/X-ray "X-ray") - [Electrocardiogram](https://en.wikipedia.org/wiki/Electrocardiograph "Electrocardiograph") If diagnosis remains unclear after history, examination, and basic investigations as above, then more advanced investigations may reveal a diagnosis. Such tests include:[\[20\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Cartwright_2008-20) - [Computed tomography](https://en.wikipedia.org/wiki/Computed_tomography "Computed tomography") of the abdomen/pelvis - Abdominal or pelvic [ultrasound](https://en.wikipedia.org/wiki/Ultrasound "Ultrasound") - [Endoscopy](https://en.wikipedia.org/wiki/Endoscopy "Endoscopy") or [colonoscopy](https://en.wikipedia.org/wiki/Colonoscopy "Colonoscopy") ## Management \[[edit](https://en.wikipedia.org/w/index.php?title=Abdominal_pain&action=edit&section=15 "Edit section: Management")\] The management of abdominal pain depends on many factors, including the etiology of the pain. Some behavioural changes implemented to prevent pain include: resting after a meal, chewing food completely and slowly, and avoiding stressful and high excitement situations after a meal. Such at home strategies may reduce the need to seek professional assistance via prevention of future abdominal pain.[\[21\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-21) In the emergency department, a person presenting with abdominal pain may initially require IV fluids due to decreased intake secondary to abdominal pain and possible emesis or vomiting.[\[22\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Mahadevan-22) Treatment for abdominal pain includes analgesia, such as non-opioid (ketorolac) and opioid medications ([morphine](https://en.wikipedia.org/wiki/Morphine "Morphine"), [fentanyl](https://en.wikipedia.org/wiki/Fentanyl "Fentanyl")).[\[22\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Mahadevan-22) Choice of [analgesia](https://en.wikipedia.org/wiki/Analgesia "Analgesia") is dependent on the cause of the pain, as [ketorolac](https://en.wikipedia.org/wiki/Ketorolac "Ketorolac") can worsen some intra-abdominal processes.[\[22\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Mahadevan-22) Patients presenting to the emergency department with abdominal pain may receive a "GI cocktail" that includes an [antacid](https://en.wikipedia.org/wiki/Antacid "Antacid") (examples include [omeprazole](https://en.wikipedia.org/wiki/Omeprazole "Omeprazole"), [famotidine](https://en.wikipedia.org/wiki/Famotidine "Famotidine"), [magnesium hydroxide](https://en.wikipedia.org/wiki/Magnesium_hydroxide "Magnesium hydroxide"), and [calcium carbonate](https://en.wikipedia.org/wiki/Calcium_carbonate "Calcium carbonate")) and [lidocaine](https://en.wikipedia.org/wiki/Lidocaine "Lidocaine").[\[22\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Mahadevan-22) After addressing pain, there may be a role for [antimicrobial](https://en.wikipedia.org/wiki/Antimicrobial "Antimicrobial") treatment in some cases of abdominal pain.[\[22\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Mahadevan-22) [Butylscopolamine](https://en.wikipedia.org/wiki/Butylscopolamine "Butylscopolamine") (Buscopan) is used to treat cramping abdominal pain with some success.[\[23\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-23) Surgical management for causes of abdominal pain includes but is not limited to [cholecystectomy](https://en.wikipedia.org/wiki/Cholecystectomy "Cholecystectomy"), [appendectomy](https://en.wikipedia.org/wiki/Appendectomy "Appendectomy"), and exploratory [laparotomy](https://en.wikipedia.org/wiki/Laparotomy "Laparotomy").\[[citation needed](https://en.wikipedia.org/wiki/Wikipedia:Citation_needed "Wikipedia:Citation needed")\] ### Emergencies \[[edit](https://en.wikipedia.org/w/index.php?title=Abdominal_pain&action=edit&section=16 "Edit section: Emergencies")\] Below is a brief overview of abdominal pain emergencies. \| Condition \| Presentation \| Diagnosis \| Management \| \|---\|---\|---\|---\| \| [Appendicitis](https://en.wikipedia.org/wiki/Appendicitis "Appendicitis")[\[24\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Sherman_2016-24) \| Abdominal pain, nausea, vomiting, fever Periumbilical pain, migrates to RLQ \| Clinical (history and physical exam) Abdominal CT \| Patient made NPO (nothing by mouth) IV fluids as neededGeneral surgery consultation, possible [appendectomy](https://en.wikipedia.org/wiki/Appendectomy "Appendectomy")AntibioticsPain control \| \| [Cholecystitis](https://en.wikipedia.org/wiki/Cholecystitis "Cholecystitis")[\[24\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Sherman_2016-24) \| Abdominal pain (RUQ, radiates epigastric), nausea, vomiting, fever, [Murphy's sign](https://en.wikipedia.org/wiki/Murphy%27s_sign "Murphy's sign") \| Clinical (history and physical exam) Imaging (RUQ ultrasound)Labs ([leukocytosis](https://en.wikipedia.org/wiki/Leukocytosis "Leukocytosis"), [transamintis](https://en.wikipedia.org/wiki/Elevated_transaminases "Elevated transaminases"), [hyperbilirubinemia](https://en.wikipedia.org/wiki/Hyperbilirubinemia "Hyperbilirubinemia")) \| Patient made NPO (nothing by mouth) IV fluids as neededGeneral surgery consultation, possible [cholecystectomy](https://en.wikipedia.org/wiki/Cholecystectomy "Cholecystectomy")AntibioticsPain, nausea control \| \| [Acute pancreatitis](https://en.wikipedia.org/wiki/Acute_pancreatitis "Acute pancreatitis")[\[24\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Sherman_2016-24) \| Abdominal pain (sharp epigastric, shooting to back), nausea, vomiting \| Clinical (history and physical exam) Labs (elevated [lipase](https://en.wikipedia.org/wiki/Lipase "Lipase"))Imaging (abdominal CT, ultrasound) \| Patient made NPO (nothing by mouth) IV fluids as neededPain, nausea controlPossibly consultation of [general surgery](https://en.wikipedia.org/wiki/Surgery "Surgery") or [interventional radiology](https://en.wikipedia.org/wiki/Interventional_radiology "Interventional radiology") \| \| [Bowel obstruction](https://en.wikipedia.org/wiki/Bowel_obstruction "Bowel obstruction")[\[24\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Sherman_2016-24) \| Abdominal pain (diffuse, crampy), [bilious](https://en.wikipedia.org/wiki/Bile "Bile") [emesis](https://en.wikipedia.org/wiki/Vomiting "Vomiting"), [constipation](https://en.wikipedia.org/wiki/Constipation "Constipation") \| Clinical (history and physical exam) Imaging (abdominal X-ray, abdominal CT) \| Patient made NPO (nothing by mouth) IV fluids as needed[Nasogastric tube](https://en.wikipedia.org/wiki/Nasogastric_intubation "Nasogastric intubation") placement[General surgery](https://en.wikipedia.org/wiki/General_surgery "General surgery") consultationPain control \| \| [Upper GI bleed](https://en.wikipedia.org/wiki/Upper_gastrointestinal_bleeding "Upper gastrointestinal bleeding")[\[24\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Sherman_2016-24) \| Abdominal pain (epigastric), [hematochezia](https://en.wikipedia.org/wiki/Hematochezia "Hematochezia"), [melena](https://en.wikipedia.org/wiki/Melena "Melena"), [hematemesis](https://en.wikipedia.org/wiki/Hematemesis "Hematemesis"), [hypovolemia](https://en.wikipedia.org/wiki/Hypovolemia "Hypovolemia") \| Clinical (history & physical exam, including [digital rectal exam](https://en.wikipedia.org/wiki/Rectal_examination "Rectal examination")) Labs ([complete blood count](https://en.wikipedia.org/wiki/Complete_blood_count "Complete blood count"), coagulation profile, [transaminases](https://en.wikipedia.org/wiki/Transaminase "Transaminase"), [stool guaiac](https://en.wikipedia.org/wiki/Stool_guaiac_test "Stool guaiac test")) \| Aggressive IV fluid resuscitation [Blood transfusion](https://en.wikipedia.org/wiki/Blood_transfusion "Blood transfusion") as neededMedications: [proton pump inhibitor](https://en.wikipedia.org/wiki/Proton-pump_inhibitor "Proton-pump inhibitor"), [octreotide](https://en.wikipedia.org/wiki/Octreotide "Octreotide")Stable patient: observationUnstable patient: consultation ([general surgery](https://en.wikipedia.org/wiki/General_surgery "General surgery"), [gastroenterology](https://en.wikipedia.org/wiki/Gastroenterology "Gastroenterology"), [interventional radiology](https://en.wikipedia.org/wiki/Interventional_radiology "Interventional radiology")) \| \| Lower [GI bleed](https://en.wikipedia.org/wiki/Gastrointestinal_bleeding "Gastrointestinal bleeding")[\[24\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Sherman_2016-24) \| Abdominal pain, [hematochezia](https://en.wikipedia.org/wiki/Hematochezia "Hematochezia"), [melena](https://en.wikipedia.org/wiki/Melena "Melena"), [hypovolemia](https://en.wikipedia.org/wiki/Hypovolemia "Hypovolemia") \| Clinical (history and physical exam, including [digital rectal exam](https://en.wikipedia.org/wiki/Rectal_examination "Rectal examination")) Labs ([complete blood count](https://en.wikipedia.org/wiki/Complete_blood_count "Complete blood count"), coagulation profile, [transaminases](https://en.wikipedia.org/wiki/Transaminase "Transaminase"), [stool guaiac](https://en.wikipedia.org/wiki/Stool_guaiac_test "Stool guaiac test")) \| Aggressive IV fluid resuscitation [Blood transfusion](https://en.wikipedia.org/wiki/Blood_transfusion "Blood transfusion") as neededMedications: [proton pump inhibitor](https://en.wikipedia.org/wiki/Proton-pump_inhibitor "Proton-pump inhibitor")Stable patient: observationUnstable patient: consultation ([general surgery](https://en.wikipedia.org/wiki/General_surgery "General surgery"), [gastroenterology](https://en.wikipedia.org/wiki/Gastroenterology "Gastroenterology"), [interventional radiology](https://en.wikipedia.org/wiki/Interventional_radiology "Interventional radiology")) \| \| Perforated Viscous[\[24\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Sherman_2016-24) \| Abdominal pain (sudden onset of localized pain), [abdominal distension](https://en.wikipedia.org/wiki/Abdominal_distension "Abdominal distension"), rigid abdomen \| Clinical (history and physical exam) Imaging (abdominal X-ray or CT showing free air)Labs ([complete blood count](https://en.wikipedia.org/wiki/Complete_blood_count "Complete blood count")) \| Aggressive IV fluid resuscitation [General surgery](https://en.wikipedia.org/wiki/General_surgery "General surgery") consultationAntibiotics \| \| [Volvulus](https://en.wikipedia.org/wiki/Volvulus "Volvulus")[\[24\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Sherman_2016-24) \| [Sigmoid colon volvulus](https://en.wikipedia.org/wiki/Sigmoid_colon_volvulus "Sigmoid colon volvulus"): Abdominal pain (\>2 days, distention, constipation) Cecal volvulus: Abdominal pain (acute onset), nausea, vomiting \| Clinical (history and physical exam) Imaging (abdominal X-ray or CT) \| Sigmoid: [Gastroenterology](https://en.wikipedia.org/wiki/Gastroenterology "Gastroenterology") consultation ([flexibile sigmoidoscopy](https://en.wikipedia.org/wiki/Sigmoidoscopy "Sigmoidoscopy")) Cecal: [General surgery](https://en.wikipedia.org/wiki/General_surgery "General surgery") consultation ([right hemicolectomy](https://en.wikipedia.org/wiki/Colectomy "Colectomy")) \| \| [Ectopic pregnancy](https://en.wikipedia.org/wiki/Ectopic_pregnancy "Ectopic pregnancy")[\[24\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Sherman_2016-24) \| Abdominal and pelvic pain, bleeding If ruptured ectopic pregnancy, the patient may present with peritoneal irritation and [hypovolemic shock](https://en.wikipedia.org/wiki/Hypovolemic_shock "Hypovolemic shock") \| Clinical (history and physical exam) Labs: [complete blood count](https://en.wikipedia.org/wiki/Complete_blood_count "Complete blood count"), urine pregnancy test followed with quantitative blood [beta-hCG](https://en.wikipedia.org/wiki/Human_chorionic_gonadotropin "Human chorionic gonadotropin")Imaging: [transvaginal ultrasound](https://en.wikipedia.org/wiki/Vaginal_ultrasonography "Vaginal ultrasonography") \| If patient is unstable: IV fluid resuscitation, urgent [obstetrics and gynecology](https://en.wikipedia.org/wiki/Obstetrics_and_gynaecology "Obstetrics and gynaecology") consultation If patient is stable: continue diagnostic workup, establish [OBGYN](https://en.wikipedia.org/wiki/Obstetrics_and_gynaecology "Obstetrics and gynaecology") follow-up \| \| [Abdominal aortic aneurysm](https://en.wikipedia.org/wiki/Abdominal_aortic_aneurysm "Abdominal aortic aneurysm")[\[24\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Sherman_2016-24) \| Abdominal pain, flank pain, back pain, hypotension, pulsatile abdominal mass \| Clinical (history and physical exam) Imaging: Ultrasound, [CT angiography](https://en.wikipedia.org/wiki/Computed_tomography_angiography "Computed tomography angiography"), MRA/[magnetic resonance angiography](https://en.wikipedia.org/wiki/Magnetic_resonance_angiography "Magnetic resonance angiography") \| If patient is unstable: IV fluid resuscitation, urgent surgical consultation If patient is stable: admit for observation \| \| [Aortic dissection](https://en.wikipedia.org/wiki/Aortic_dissection "Aortic dissection")[\[24\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Sherman_2016-24) \| Abdominal pain (sudden onset of epigastric or back pain), hypertension, new aortic [murmur](https://en.wikipedia.org/wiki/Heart_murmur "Heart murmur") \| Clinical (history and physical exam) Imaging: Chest X-ray (showing widened [mediastinum](https://en.wikipedia.org/wiki/Mediastinum "Mediastinum")), [CT angiography](https://en.wikipedia.org/wiki/Computed_tomography_angiography "Computed tomography angiography"), [MRA](https://en.wikipedia.org/wiki/Magnetic_resonance_angiography "Magnetic resonance angiography"), [transthoracic echocardiogram](https://en.wikipedia.org/wiki/Transthoracic_echocardiogram "Transthoracic echocardiogram")/TTE, [transesophageal echocardiogram](https://en.wikipedia.org/wiki/Transesophageal_echocardiogram "Transesophageal echocardiogram")/TEE \| IV fluid resuscitation [Blood transfusion](https://en.wikipedia.org/wiki/Blood_transfusion "Blood transfusion") as needed (obtain [type and cross](https://en.wikipedia.org/wiki/Blood_transfusion "Blood transfusion"))Medications: reduce blood pressure ([sodium nitroprusside](https://en.wikipedia.org/wiki/Sodium_nitroprusside "Sodium nitroprusside") plus [beta blocker](https://en.wikipedia.org/wiki/Beta_blocker "Beta blocker") or [calcium channel blocker](https://en.wikipedia.org/wiki/Calcium_channel_blocker "Calcium channel blocker"))Surgery consultation \| \| [Liver injury](https://en.wikipedia.org/wiki/Liver_injury "Liver injury")[\[24\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Sherman_2016-24) \| After trauma ([blunt](https://en.wikipedia.org/wiki/Blunt_trauma "Blunt trauma") or [penetrating](https://en.wikipedia.org/wiki/Penetrating_trauma "Penetrating trauma")), abdominal pain (RUQ), right rib pain, right flank pain, right shoulder pain \| Clinical (history and physical exam) Imaging: [FAST](https://en.wikipedia.org/wiki/Focused_assessment_with_sonography_for_trauma "Focused assessment with sonography for trauma") examination, CT of abdomen and pelvis[Diagnostic peritoneal aspiration and lavage](https://en.wikipedia.org/wiki/Diagnostic_peritoneal_lavage "Diagnostic peritoneal lavage") \| Resuscitation ([advanced trauma life support](https://en.wikipedia.org/wiki/Advanced_trauma_life_support "Advanced trauma life support")) with IV fluids ([crystalloid](https://en.wikipedia.org/wiki/Fluid_replacement "Fluid replacement")) and [blood transfusion](https://en.wikipedia.org/wiki/Blood_transfusion "Blood transfusion") If patient is unstable: [general](https://en.wikipedia.org/wiki/General_surgery "General surgery") or [trauma surgery](https://en.wikipedia.org/wiki/Trauma_surgery "Trauma surgery") consultation with subsequent [exploratory laparotomy](https://en.wikipedia.org/wiki/Exploratory_laparotomy "Exploratory laparotomy") \| \| [Splenic injury](https://en.wikipedia.org/wiki/Splenic_injury "Splenic injury")[\[24\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Sherman_2016-24) \| After trauma ([blunt](https://en.wikipedia.org/wiki/Blunt_trauma "Blunt trauma") or [penetrating](https://en.wikipedia.org/wiki/Penetrating_trauma "Penetrating trauma")), abdominal pain (LUQ), left rib pain, left flank pain \| Clinical (history and physical exam) Imaging: [FAST](https://en.wikipedia.org/wiki/Focused_assessment_with_sonography_for_trauma "Focused assessment with sonography for trauma") examination, CT of abdomen and pelvis[Diagnostic peritoneal aspiration and lavage](https://en.wikipedia.org/wiki/Diagnostic_peritoneal_lavage "Diagnostic peritoneal lavage") \| Resuscitation ([advanced trauma life support](https://en.wikipedia.org/wiki/Advanced_trauma_life_support "Advanced trauma life support")) with IV fluids ([crystalloid](https://en.wikipedia.org/wiki/Fluid_replacement "Fluid replacement")) and [blood transfusion](https://en.wikipedia.org/wiki/Blood_transfusion "Blood transfusion") If patient is unstable: [general](https://en.wikipedia.org/wiki/General_surgery "General surgery") or [trauma surgery](https://en.wikipedia.org/wiki/Trauma_surgery "Trauma surgery") consultation with subsequent [exploratory laparotomy](https://en.wikipedia.org/wiki/Exploratory_laparotomy "Exploratory laparotomy") and possible [splenectomy](https://en.wikipedia.org/wiki/Splenectomy "Splenectomy")If patient is stable: medical management, consultation of [interventional radiology](https://en.wikipedia.org/wiki/Interventional_radiology "Interventional radiology") for possible [arterial embolization](https://en.wikipedia.org/wiki/Embolization "Embolization") \| ## Outlook \[[edit](https://en.wikipedia.org/w/index.php?title=Abdominal_pain&action=edit&section=17 "Edit section: Outlook")\] One well-known aspect of primary health care is its low prevalence of potentially dangerous abdominal pain causes. Patients with abdominal pain have a higher percentage of unexplained complaints (category "no diagnosis") than patients with other symptoms (such as [dyspnea](https://en.wikipedia.org/wiki/Dyspnea "Dyspnea") or [chest pain](https://en.wikipedia.org/wiki/Chest_pain "Chest pain")).[\[25\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-A_C_T_R_p.-25) Most people who suffer from stomach pain have a benign issue, like [dyspepsia](https://en.wikipedia.org/wiki/Indigestion "Indigestion").[\[26\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Gulacti_Arslan_Ooi_Tuck_2001_pp._123%E2%80%93136-26) In general, it is discovered that 20% to 25% of patients with abdominal pain have a serious condition that necessitates admission to an acute care hospital.[\[27\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Chandramohan_Pari_Schrock_Lum_1991_pp._503%E2%80%93507-27) ## Epidemiology \[[edit](https://en.wikipedia.org/w/index.php?title=Abdominal_pain&action=edit&section=18 "Edit section: Epidemiology")\] Abdominal pain is the reason about 3% of adults see their family physician.[\[2\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Vin2014-2) Rates of [emergency department](https://en.wikipedia.org/wiki/Emergency_department "Emergency department") (ED) visits in the United States for abdominal pain increased 18% from 2006 through to 2011. This was the largest increase out of 20 common conditions seen in the ED. The rate of ED use for nausea and vomiting also increased 18%.[\[28\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-28) ## Special populations \[[edit](https://en.wikipedia.org/w/index.php?title=Abdominal_pain&action=edit&section=19 "Edit section: Special populations")\] ### Geriatrics \[[edit](https://en.wikipedia.org/w/index.php?title=Abdominal_pain&action=edit&section=20 "Edit section: Geriatrics")\] More time and resources are used on older patients with abdominal pain than on any other patient presentation in the emergency department (ED).[\[29\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-SA_LZ_p.-29) Compared to younger patients with the same complaint, their length of stay is 20% longer, they need to be admitted almost half the time, and they need surgery 1/3 of the time.[\[30\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Rodr%C3%ADguez-Lomba_Pulido-P%C3%A9rez_Ricciardi_Marcello_1976_pp._219%E2%80%93223-30) Age does not reduce the total number of [T cells](https://en.wikipedia.org/wiki/T_cell "T cell"), but it does reduce their functionality. The elderly person's ability to fight infection is weakened as a result.[\[31\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Weyand_Goronzy_p.-31) Additionally, they have changed the strength and integrity of their skin and [mucous membranes](https://en.wikipedia.org/wiki/Mucous_membrane "Mucous membrane"), which are physical barriers to infection. It is well known that older patients experience altered pain perception.[\[32\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Sherman_p.-32) The challenge of obtaining a sufficient history from an elderly patient can be attributed to multiple factors. Reduced memory or hearing could make the issue worse. It is common to encounter stoicism combined with a fear of losing one's independence if a serious condition is discovered. Changes in mental status, whether acute or chronic, are common.[\[33\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Isani_Kim_Mateu_Tormo_2006_pp._371%E2%80%93388-33) ### Pregnancy \[[edit](https://en.wikipedia.org/w/index.php?title=Abdominal_pain&action=edit&section=21 "Edit section: Pregnancy")\] Unique clinical challenges arise when pregnant women experience abdominal pain. First off, there are many possible causes of abdominal pain during pregnancy. These include intraabdominal diseases that arise incidentally during pregnancy as well as obstetric or gynecologic disorders associated with pregnancy. Secondly, pregnancy modifies the natural history and clinical manifestation of numerous abdominal disorders.[\[34\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-34) Third, pregnancy modifies and limits the diagnostic assessment. For instance, concerns about fetal safety during pregnancy are raised by invasive exams and radiologic testing. Fourth, while receiving therapy during pregnancy, the mother's and the fetus' interests need to be taken into account.[\[35\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Souza_Ferreira_Young_Cerit_2003_pp._1%E2%80%9358-35) ## See also \[[edit](https://en.wikipedia.org/w/index.php?title=Abdominal_pain&action=edit&section=22 "Edit section: See also")\] - [Abdominal distension](https://en.wikipedia.org/wiki/Abdominal_distension "Abdominal distension") - [Abdominal mass](https://en.wikipedia.org/wiki/Abdominal_mass "Abdominal mass") ## References \[[edit](https://en.wikipedia.org/w/index.php?title=Abdominal_pain&action=edit&section=23 "Edit section: References")\] 1. [^](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Stat2018_1-0) Patterson JW, Dominique E (14 November 2018). "Acute Abdomenal". StatPearls. [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [29083722](https://pubmed.ncbi.nlm.nih.gov/29083722). 2. ^ [*a](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Vin2014_2-0) [b](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Vin2014_2-1) [c](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Vin2014_2-2) [d](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Vin2014_2-3) [e](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Vin2014_2-4) Viniol A, Keunecke C, Biroga T, Stadje R, Dornieden K, Bösner S, et al. (October 2014). ["Studies of the symptom abdominal pain—a systematic review and meta-analysis"](https://doi.org/10.1093%2Ffampra%2Fcmu036). Family Practice. 31* (5): 517–29\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1093/fampra/cmu036](https://doi.org/10.1093%2Ffampra%2Fcmu036). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [24987023](https://pubmed.ncbi.nlm.nih.gov/24987023). 3. ^ [*a](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Hopcroft2020_3-0) [b](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Hopcroft2020_3-1) Hopcroft K, Forte V (2020). ["Abdomen"](https://books.google.com/books?id=pr_gDwAAQBAJ&pg=PA9). Symptom Sorter* (6th ed.). Boca Raton: CRC Press. pp. 9–17\. [ISBN](https://en.wikipedia.org/wiki/ISBN_\(identifier\) "ISBN (identifier)") [9780367468101](https://en.wikipedia.org/wiki/Special:BookSources/9780367468101 "Special:BookSources/9780367468101") . 4. ^ [*a](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Sherman_1990_r770_4-0) [b](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Sherman_1990_r770_4-1) Sherman R (1990). [Abdominal Pain](https://www.ncbi.nlm.nih.gov/books/NBK412/). Butterworths. [ISBN](https://en.wikipedia.org/wiki/ISBN_\(identifier\) "ISBN (identifier)") [978-0-409-90077-4](https://en.wikipedia.org/wiki/Special:BookSources/978-0-409-90077-4 "Special:BookSources/978-0-409-90077-4") . [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [21250252](https://pubmed.ncbi.nlm.nih.gov/21250252). Retrieved 28 December 2023. 5. [^](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-5)* Hung A, Calderbank T, Samaan MA, Plumb AA, Webster G (1 January 2021). ["Ischaemic colitis: practical challenges and evidence-based recommendations for management"](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7802492). Frontline Gastroenterology. 12 (1): 44–52\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1136/flgastro-2019-101204](https://doi.org/10.1136%2Fflgastro-2019-101204). [ISSN](https://en.wikipedia.org/wiki/ISSN_\(identifier\) "ISSN (identifier)") [2041-4137](https://search.worldcat.org/issn/2041-4137). [PMC](https://en.wikipedia.org/wiki/PMC_\(identifier\) "PMC (identifier)") [7802492](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7802492). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [33489068](https://pubmed.ncbi.nlm.nih.gov/33489068). 6. [^](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Spangler_2014_6-0) Spangler R, Van Pham T, Khoujah D, Martinez JP (2014). ["Abdominal emergencies in the geriatric patient"](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4306086). International Journal of Emergency Medicine. 7 43. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1186/s12245-014-0043-2](https://doi.org/10.1186%2Fs12245-014-0043-2). [PMC](https://en.wikipedia.org/wiki/PMC_\(identifier\) "PMC (identifier)") [4306086](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4306086). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [25635203](https://pubmed.ncbi.nlm.nih.gov/25635203). 7. ^ [*a](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-aa_7-0) [b](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-aa_7-1) [c](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-aa_7-2) [d](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-aa_7-3) [e](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-aa_7-4) Patterson JW, Kashyap S, Dominique E (2023), ["Acute Abdomen"](https://www.ncbi.nlm.nih.gov/books/NBK459328/), StatPearls, Treasure Island (FL): StatPearls Publishing, [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [29083722](https://pubmed.ncbi.nlm.nih.gov/29083722), retrieved 23 September 2023 8. [^](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-8)* ["Appendicitis"](https://www.lecturio.com/concepts/appendicitis/). The Lecturio Medical Concept Library. Retrieved 1 July 2021. 9. [^](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-9) Arendt-Nielsen L, Svensson P (March 2001). ["Referred Muscle Pain: Basic and Clinical Findings"](https://doi.org/10.1097%2F00002508-200103000-00003). The Clinical Journal of Pain. 17 (1): 11–19\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1097/00002508-200103000-00003](https://doi.org/10.1097%2F00002508-200103000-00003). [ISSN](https://en.wikipedia.org/wiki/ISSN_\(identifier\) "ISSN (identifier)") [0749-8047](https://search.worldcat.org/issn/0749-8047). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [11289083](https://pubmed.ncbi.nlm.nih.gov/11289083). 10. [^](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-10) Collantes Celador E, Rudiger J, Tameem A, eds. (2022). Essential Notes in Pain Medicine (1st ed.). United Kingdom: Oxford University Press. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1093/med/9780198799443.001.0001](https://doi.org/10.1093%2Fmed%2F9780198799443.001.0001). [ISBN](https://en.wikipedia.org/wiki/ISBN_\(identifier\) "ISBN (identifier)") [978-0-19-879944-3](https://en.wikipedia.org/wiki/Special:BookSources/978-0-19-879944-3 "Special:BookSources/978-0-19-879944-3") . 11. [^](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-11) Burnett LS (April 1988). "Gynecologic causes of the acute abdomen". The Surgical Clinics of North America. 68 (2): 385–398\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1016/s0039-6109(16)44484-1](https://doi.org/10.1016%2Fs0039-6109%2816%2944484-1). [ISSN](https://en.wikipedia.org/wiki/ISSN_\(identifier\) "ISSN (identifier)") [0039-6109](https://search.worldcat.org/issn/0039-6109). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [3279553](https://pubmed.ncbi.nlm.nih.gov/3279553). 12. [^](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-12) Masters P (2015). IM Essentials. American College of Physicians. [ISBN](https://en.wikipedia.org/wiki/ISBN_\(identifier\) "ISBN (identifier)") [978-1-938921-09-4](https://en.wikipedia.org/wiki/Special:BookSources/978-1-938921-09-4 "Special:BookSources/978-1-938921-09-4") . 13. [^](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-13) LeBlond RF (2004). Diagnostics. US: McGraw-Hill Companies, Inc. [ISBN](https://en.wikipedia.org/wiki/ISBN_\(identifier\) "ISBN (identifier)") [978-0-07-140923-0](https://en.wikipedia.org/wiki/Special:BookSources/978-0-07-140923-0 "Special:BookSources/978-0-07-140923-0") . 14. ^ [*a](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Moore_2016_14-0) [b](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Moore_2016_14-1) [c](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Moore_2016_14-2) [d](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Moore_2016_14-3) [e](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Moore_2016_14-4) [f](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Moore_2016_14-5) Moore KL (2016). "11". The Developing Human Tenth Edition. Philadelphia, PA: Elsevier, Inc. pp. 209–240\. [ISBN](https://en.wikipedia.org/wiki/ISBN_\(identifier\) "ISBN (identifier)") [978-0-323-31338-4](https://en.wikipedia.org/wiki/Special:BookSources/978-0-323-31338-4 "Special:BookSources/978-0-323-31338-4") . 15. [^](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-15)* Hansen JT (2019). "4: Abdomen". Netter's Clinical Anatomy, 4e. Philadelphia, PA: Elsevier. pp. 157–231\. [ISBN](https://en.wikipedia.org/wiki/ISBN_\(identifier\) "ISBN (identifier)") [978-0-323-53188-7](https://en.wikipedia.org/wiki/Special:BookSources/978-0-323-53188-7 "Special:BookSources/978-0-323-53188-7") . 16. [^](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-16) Drake RL, Vogl AW, Mitchell AW (2015). "4: Abdomen". Gray's Anatomy For Students (Third ed.). Churchill Livingstone Elsevier. pp. 253–420\. [ISBN](https://en.wikipedia.org/wiki/ISBN_\(identifier\) "ISBN (identifier)") [978-0-7020-5131-9](https://en.wikipedia.org/wiki/Special:BookSources/978-0-7020-5131-9 "Special:BookSources/978-0-7020-5131-9") . 17. ^ [*a](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Neumayer_2013_17-0) [b](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Neumayer_2013_17-1) Neumayer L, Dangleben DA, Fraser S, Gefen J, Maa J, Mann BD (2013). "11: Abdominal Wall, Including Hernia". Essentials of General Surgery, 5e. Baltimore, MD: Wolters Kluwer Health. 18. ^ [a](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Bickley_2016_18-0) [b](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Bickley_2016_18-1) Bickley L (2016). Bates' Guide to Physical Examination & History Taking. Philadelphia, Pennsylvania: Lippincott Williams & Wilkins. [ISBN](https://en.wikipedia.org/wiki/ISBN_\(identifier\) "ISBN (identifier)") [978-1-4698-9341-9](https://en.wikipedia.org/wiki/Special:BookSources/978-1-4698-9341-9 "Special:BookSources/978-1-4698-9341-9") . 19. [^](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-19)* Karen M. Myrick, Laima Karosas (6 December 2019). [Advanced Health Assessment and Differential Diagnosis: Essentials for Clinical Practice](https://books.google.com/books?id=QTCeDwAAQBAJ&q=%22Carnett's+sign%22+diagnosis). Springer Publishing Company. p. 250. [ISBN](https://en.wikipedia.org/wiki/ISBN_\(identifier\) "ISBN (identifier)") [978-0-8261-6255-7](https://en.wikipedia.org/wiki/Special:BookSources/978-0-8261-6255-7 "Special:BookSources/978-0-8261-6255-7") . 20. ^ [*a](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Cartwright_2008_20-0) [b](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Cartwright_2008_20-1) Cartwright SL, Knudson MP (April 2008). ["Evaluation of acute abdominal pain in adults"](http://www.aafp.org/afp/2008/0401/p971.html). American Family Physician. 77* (7): 971–8\. [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [18441863](https://pubmed.ncbi.nlm.nih.gov/18441863). 21. [^](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-21) ["Indigestion: MedlinePlus Medical Encyclopedia"](https://medlineplus.gov/ency/article/003260.htm). medlineplus.gov. Retrieved 2 May 2023. 22. ^ [*a](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Mahadevan_22-0) [b](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Mahadevan_22-1) [c](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Mahadevan_22-2) [d](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Mahadevan_22-3) [e](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Mahadevan_22-4) Mahadevan SV. Essentials of Family Medicine 6e. p. 149. 23. [^](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-23)* Tytgat GN (2007). "Hyoscine butylbromide: a review of its use in the treatment of abdominal cramping and pain". Drugs. 67 (9): 1343–57\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.2165/00003495-200767090-00007](https://doi.org/10.2165%2F00003495-200767090-00007). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [17547475](https://pubmed.ncbi.nlm.nih.gov/17547475). [S2CID](https://en.wikipedia.org/wiki/S2CID_\(identifier\) "S2CID (identifier)") [46971321](https://api.semanticscholar.org/CorpusID:46971321). 24. ^ [*a](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Sherman_2016_24-0) [b](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Sherman_2016_24-1) [c](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Sherman_2016_24-2) [d](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Sherman_2016_24-3) [e](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Sherman_2016_24-4) [f](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Sherman_2016_24-5) [g](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Sherman_2016_24-6) [h](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Sherman_2016_24-7) [i](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Sherman_2016_24-8) [j](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Sherman_2016_24-9) [k](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Sherman_2016_24-10) [l](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Sherman_2016_24-11) [m](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Sherman_2016_24-12) Sherman SC, Cico SJ, Nordquist E, Ross C, Wang E (2016). Atlas of Clinical Emergency Medicine. Wolters Kluwer. [ISBN](https://en.wikipedia.org/wiki/ISBN_\(identifier\) "ISBN (identifier)") [978-1-4511-8882-0](https://en.wikipedia.org/wiki/Special:BookSources/978-1-4511-8882-0 "Special:BookSources/978-1-4511-8882-0") . 25. [^](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-A_C_T_R_p._25-0)* Viniol A, Keunecke C, Biroga T, Stadje R, Dornieden K, Bösner S, et al. (2014). "Studies of the symptom abdominal pain—a systematic review and meta-analysis". Family Practice. 31 (5): 517–529\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1093/fampra/cmu036](https://doi.org/10.1093%2Ffampra%2Fcmu036). [ISSN](https://en.wikipedia.org/wiki/ISSN_\(identifier\) "ISSN (identifier)") [1460-2229](https://search.worldcat.org/issn/1460-2229). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [24987023](https://pubmed.ncbi.nlm.nih.gov/24987023). 26. [^](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Gulacti_Arslan_Ooi_Tuck_2001_pp._123%E2%80%93136_26-0) Gulacti U, Arslan E, Ooi MW, Tuck J, Mattu A, Dubosh NM, et al. (1 February 2001). "Abdominal Pain and Emergency Department Evaluation". Emergency Medicine Clinics of North America. 19 (1). Elsevier: 123–136\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1016/S0733-8627(05)70171-1](https://doi.org/10.1016%2FS0733-8627%2805%2970171-1). [ISSN](https://en.wikipedia.org/wiki/ISSN_\(identifier\) "ISSN (identifier)") [0733-8627](https://search.worldcat.org/issn/0733-8627). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [11214394](https://pubmed.ncbi.nlm.nih.gov/11214394). 27. [^](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Chandramohan_Pari_Schrock_Lum_1991_pp._503%E2%80%93507_27-0) Chandramohan R, Pari L, Schrock JW, Lum M, Örnek N, Usta G, et al. (1 May 1991). "Probability of appendicitis before and after observation". Annals of Emergency Medicine. 20 (5). Mosby: 503–507\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1016/S0196-0644(05)81603-8](https://doi.org/10.1016%2FS0196-0644%2805%2981603-8). [ISSN](https://en.wikipedia.org/wiki/ISSN_\(identifier\) "ISSN (identifier)") [0196-0644](https://search.worldcat.org/issn/0196-0644). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [2024789](https://pubmed.ncbi.nlm.nih.gov/2024789). 28. [^](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-28) Skiner HG, Blanchard J, Elixhauser A (September 2014). ["Trends in Emergency Department Visits, 2006–2011"](https://www.hcup-us.ahrq.gov/reports/statbriefs/sb179-Emergency-Department-Trends.jsp). HCUP Statistical Brief (179). Rockville, MD: Agency for Healthcare Research and Quality. 29. [^](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-SA_LZ_p._29-0) Baum SA, Rubenstein LZ (1987). "Old people in the emergency room: age-related differences in emergency department use and care". Journal of the American Geriatrics Society. 35 (5): 398–404\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1111/j.1532-5415.1987.tb04660.x](https://doi.org/10.1111%2Fj.1532-5415.1987.tb04660.x). [ISSN](https://en.wikipedia.org/wiki/ISSN_\(identifier\) "ISSN (identifier)") [0002-8614](https://search.worldcat.org/issn/0002-8614). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [3571788](https://pubmed.ncbi.nlm.nih.gov/3571788). [S2CID](https://en.wikipedia.org/wiki/S2CID_\(identifier\) "S2CID (identifier)") [30731138](https://api.semanticscholar.org/CorpusID:30731138). 30. [^](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Rodr%C3%ADguez-Lomba_Pulido-P%C3%A9rez_Ricciardi_Marcello_1976_pp._219%E2%80%93223_30-0) Rodríguez-Lomba E, Pulido-Pérez A, Ricciardi R, Marcello PW, Kuki I, Nakane S, et al. (1 February 1976). "Abdominal pain: An analysis of 1,000 consecutive cases in a university hospital emergency room". The American Journal of Surgery. 131 (2). Elsevier: 219–223\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1016/0002-9610(76)90101-X](https://doi.org/10.1016%2F0002-9610%2876%2990101-X). [ISSN](https://en.wikipedia.org/wiki/ISSN_\(identifier\) "ISSN (identifier)") [0002-9610](https://search.worldcat.org/issn/0002-9610). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [1251963](https://pubmed.ncbi.nlm.nih.gov/1251963). 31. [^](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Weyand_Goronzy_p._31-0) Weyand CM, Goronzy rJ (2016). ["Aging of the Immune System. Mechanisms and Therapeutic Targets"](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5291468). Annals of the American Thoracic Society. 13 (Suppl 5). American Thoracic Society: S422–S428. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1513/AnnalsATS.201602-095AW](https://doi.org/10.1513%2FAnnalsATS.201602-095AW). [PMC](https://en.wikipedia.org/wiki/PMC_\(identifier\) "PMC (identifier)") [5291468](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5291468). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [28005419](https://pubmed.ncbi.nlm.nih.gov/28005419). 32. [^](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Sherman_p._32-0) Sherman ED, Robillard E (1964). "Sensitivity to Pain in Relationship to Age". Journal of the American Geriatrics Society. 12 (11): 1037–1044\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1111/j.1532-5415.1964.tb00652.x](https://doi.org/10.1111%2Fj.1532-5415.1964.tb00652.x). [ISSN](https://en.wikipedia.org/wiki/ISSN_\(identifier\) "ISSN (identifier)") [0002-8614](https://search.worldcat.org/issn/0002-8614). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [14217863](https://pubmed.ncbi.nlm.nih.gov/14217863). [S2CID](https://en.wikipedia.org/wiki/S2CID_\(identifier\) "S2CID (identifier)") [26336124](https://api.semanticscholar.org/CorpusID:26336124). 33. [^](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Isani_Kim_Mateu_Tormo_2006_pp._371%E2%80%93388_33-0) Isani MA, Kim ES, Mateu PB, Tormo FB, Thilakarathna K, Xie G, et al. (1 May 2006). "Abdominal Pain in the Elderly". Emergency Medicine Clinics of North America. 24 (2). Elsevier: 371–388\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1016/j.emc.2006.01.010](https://doi.org/10.1016%2Fj.emc.2006.01.010). [ISSN](https://en.wikipedia.org/wiki/ISSN_\(identifier\) "ISSN (identifier)") [0733-8627](https://search.worldcat.org/issn/0733-8627). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [16584962](https://pubmed.ncbi.nlm.nih.gov/16584962). 34. [^](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-34) Odubamowo K, Chilaka C, Walker K (2022). ["Abdominal pain in late pregnancy (‡24 weeks' gestation)"](https://pdf.sciencedirectassets.com/273615/1-s2.0-S1751721422X00079/1-s2.0-S1751721422000896/main.pdf?X-Amz-Security-Token=IQoJb3JpZ2luX2VjEL%2F%2F%2F%2F%2F%2F%2F%2F%2F%2F%2FwEaCXVzLWVhc3QtMSJGMEQCIEfiqG1MrLs9dhugOfvdLbbzZ8CQzGMq2hHxNR5K689zAiAwmauFQBhwIK5hrtFv2f2TVu8zJvXG5Ud%2F6D%2BLR%2BthnSq7BQi4%2F%2F%2F%2F%2F%2F%2F%2F%2F%2F8BEAUaDDA1OTAwMzU0Njg2NSIM%2Ff%2BcEuyXVsMFuyP%2BKo8FxHw7YHdLP0CAhNNQV1kQgZ8cRfl%2BPdDPdIt2gn%2Fyrn6rAbOrIOVnWOArsf%2BCI8hJyeO%2FXewl6fAWsnfann5aQVTG8Cq%2BNywCj%2FmA5q9WtZoPfUjIPqRNVvQwug%2B%2FaNjE3T81Nzc4YKTGtIbK7ZDsM0cHk4Y13aK8oBZApvgWEKVqDuUOlLyOhLqof0CXI3Jdo1ByC8wSQM6NrJSx1jxkGJ1ln00kKV1CnIn3loMr44Elelhoc3oAzSuh9XjTZtlR%2BFUf5YZLFGBlFW4%2FBQyOnIGoSKoq0RLybw1MtV6JNII8zHhATlyTvfW6T0VfZlSL3IyXwQezMYIf1V0ILDrh%2FeG5wtMxkHhvFmtSgI7rYq4D0TaOP75pWG2Ej%2BfLW7Hx1w8H62vAmfZRYYBpWEm610umvABT4WvC584xnpyfXZAIktZX7Suxfkn1504XfntL6AjIEk3vau%2FYnPUHyyGNYyyb53l9c234nqECwtKq7zoi2yz3dnZ2nXH%2FxIXwnA5dNGgpxoC%2Bz1B9nDmK%2Bm6%2FG3YiTubgAfudLEtLBJM8Nxwtz6GyuIxEx2k1VOuk6xeuVfPHE6yTgEkw93okOrOBQU2BnW109pgjJRmmUqoEV1rQdSCAbHfrGiNxl%2BHOh8lzYdxXw7BdV7QoO5i3FgfVJbLg%2FwwC%2FTw79vwSbGkIin7NlHXrEF8UzA0b8fDICxRDtyqPvrnB%2FHuWFh7%2F%2BLRguPw%2FLMHnak3geEeMScBnMNfRZv4hWkSUsDMShHh6DobOW0uHXiOQMmIYY4jar%2Blb%2FfCL%2FizTPXbd%2FxsUmfrxuLlpChm54jE8EDBOXpAiIOU14EOxU5csVmVEkWVZX6MTK6l%2BNOz2pVt2DU7pcNLZZTDl%2B7y8BjqyAdZMwi0NbY5KdWmnMqW0nwqT6YQy%2BZVh6tWGgHdJHS9ZOEcw3nxY8mAW5yX67t%2FQiaosCSJMgOdBjXYXUeV0VeVTCq9OdU26dayIbv2a7t9mLRJJu1CqwT4YoaTxxD6vMTv0fRhtqe4czvBlrCMY31hAOHBHlLyw%2FPfWmPJYhfNRmboQD4Dkhp%2Bgxie0gOBJJwnVqe1mcIgHcnPfuVe%2FFdxBoS3jCe0O%2FH%2BI0nWF4kIlYFg%3D&X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Date=20250121T073410Z&X-Amz-SignedHeaders=host&X-Amz-Expires=300&X-Amz-Credential=ASIAQ3PHCVTYTGJZ23NM%2F20250121%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Signature=8b5eb70d56adaffdd035dc032c7cbd2c8bffcbe7c29666223a4787a2e3401f72&hash=7d590af2be0262f89488f07391ebf21f92956ceab55bffc1c8057a2f03555a8c&host=68042c943591013ac2b2430a89b270f6af2c76d8dfd086a07176afe7c76c2c61&pii=S1751721422000896&tid=spdf-ebbe3e12-1389-4ef8-9b2d-05a0726c0f84&sid=1bd83b041bcdc1463d4842e10910150a607agxrqa&type=client&tsoh=d3d3LnNjaWVuY2VkaXJlY3QuY29t&ua=1b135e5050555d0a065708&rr=90559ec6f8a687c4&cc=au) (PDF). Obstetrics, Gynaecology and Reproductive Medicine. 32 (7): 141–151\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1016/j.ogrm.2022.04.008](https://doi.org/10.1016%2Fj.ogrm.2022.04.008). 35. [^](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Souza_Ferreira_Young_Cerit_2003_pp._1%E2%80%9358_35-0) Souza Fd, Ferreira CH, Young RC, Cerit L, Lejong M, Louryan S, et al. (1 March 2003). "Abdominal pain during pregnancy". Gastroenterology Clinics of North America. 32 (1). Elsevier: 1–58\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1016/S0889-8553(02)00064-X](https://doi.org/10.1016%2FS0889-8553%2802%2900064-X). [ISSN](https://en.wikipedia.org/wiki/ISSN_\(identifier\) "ISSN (identifier)") [0889-8553](https://search.worldcat.org/issn/0889-8553). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [12635413](https://pubmed.ncbi.nlm.nih.gov/12635413). ## Further reading \[[edit](https://en.wikipedia.org/w/index.php?title=Abdominal_pain&action=edit&section=24 "Edit section: Further reading")\] - Shinar Z, Dembitsky W, Smith ME, Moak JH, Traub SJ, Saghafian S, et al. (1 September 2011). "Abdominal pain in the ED: a 35 year retrospective". The American Journal of Emergency Medicine. 29 (7). W.B. Saunders: 711–716\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1016/j.ajem.2010.01.045](https://doi.org/10.1016%2Fj.ajem.2010.01.045). [ISSN](https://en.wikipedia.org/wiki/ISSN_\(identifier\) "ISSN (identifier)") [0735-6757](https://search.worldcat.org/issn/0735-6757). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [20825873](https://pubmed.ncbi.nlm.nih.gov/20825873). - Farmer AD, Aziz Q (2014). ["Mechanisms and management of functional abdominal pain"](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4206626). Journal of the Royal Society of Medicine. 107 (9): 347–354\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1177/0141076814540880](https://doi.org/10.1177%2F0141076814540880). [ISSN](https://en.wikipedia.org/wiki/ISSN_\(identifier\) "ISSN (identifier)") [0141-0768](https://search.worldcat.org/issn/0141-0768). [PMC](https://en.wikipedia.org/wiki/PMC_\(identifier\) "PMC (identifier)") [4206626](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4206626). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [25193056](https://pubmed.ncbi.nlm.nih.gov/25193056). - Akasaka E, Sawamura D, Rokunohe D, Sawamura D, Talukdar R, Reddy DN, et al. (1 February 2006). "Abdominal Pain in Children". Pediatric Clinics of North America. 53 (1). Elsevier: 107–137\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1016/j.pcl.2005.09.009](https://doi.org/10.1016%2Fj.pcl.2005.09.009). [ISSN](https://en.wikipedia.org/wiki/ISSN_\(identifier\) "ISSN (identifier)") [0031-3955](https://search.worldcat.org/issn/0031-3955). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [16487787](https://pubmed.ncbi.nlm.nih.gov/16487787). [S2CID](https://en.wikipedia.org/wiki/S2CID_\(identifier\) "S2CID (identifier)") [17103933](https://api.semanticscholar.org/CorpusID:17103933). ## External links \[[edit](https://en.wikipedia.org/w/index.php?title=Abdominal_pain&action=edit&section=25 "Edit section: External links")\] - [![](https://upload.wikimedia.org/wikipedia/commons/thumb/d/df/Wikibooks-logo-en-noslogan.svg/20px-Wikibooks-logo-en-noslogan.svg.png)](https://en.wikipedia.org/wiki/File:Wikibooks-logo-en-noslogan.svg) [Abdominal Pain](https://en.wikibooks.org/wiki/Internal_Medicine/Abdominal_Pain "wikibooks:Internal Medicine/Abdominal Pain") at Wikibooks - [Cleveland Clinic](https://my.clevelandclinic.org/health/symptoms/4167-abdominal-pain) - [Mayo Clinic](https://www.mayoclinic.org/symptoms/abdominal-pain/basics/definition/sym-20050728) \| \| \| \|---\|---\| \| Classification \| [D](https://www.wikidata.org/wiki/Q183425 "d:Q183425") [ICD](https://en.wikipedia.org/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems "International Statistical Classification of Diseases and Related Health Problems")\-[11](https://en.wikipedia.org/wiki/ICD-11 "ICD-11"): [MD81](https://icd.who.int/browse/latest-release/mms/en#1293213417) [ICD](https://en.wikipedia.org/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems "International Statistical Classification of Diseases and Related Health Problems")\-[10](https://en.wikipedia.org/wiki/ICD-10 "ICD-10"): [R10](https://icd.who.int/browse10/2019/en#/R10) [ICD](https://en.wikipedia.org/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems "International Statistical Classification of Diseases and Related Health Problems")\-[9-CM](https://en.wikipedia.org/wiki/List_of_ICD-9_codes "List of ICD-9 codes"): [789](http://www.icd9data.com/getICD9Code.ashx?icd9=789) [MeSH](https://en.wikipedia.org/wiki/Medical_Subject_Headings "Medical Subject Headings"): [D015746](https://meshb.nlm.nih.gov/record/ui?ui=D015746) [DiseasesDB](https://en.wikipedia.org/wiki/Diseases_Database "Diseases Database"): [14367](http://www.diseasesdatabase.com/ddb14367.htm) [SNOMED CT](https://en.wikipedia.org/wiki/SNOMED_CT "SNOMED CT"): [21522001](https://browser.ihtsdotools.org/?perspective=full&conceptId1=21522001&languages=en) \| \| External resources \| [MedlinePlus](https://en.wikipedia.org/wiki/MedlinePlus "MedlinePlus"): [003120](https://www.nlm.nih.gov/medlineplus/ency/article/003120.htm) [Patient UK](https://en.wikipedia.org/wiki/Patient_UK "Patient UK"): [Abdominal pain](https://patient.info/doctor/abdominal-pain-pro) [Radiopaedia](https://en.wikipedia.org/wiki/Radiopaedia "Radiopaedia"): [47481](https://radiopaedia.org/articles/47481) Scholia: [Q183425](https://tools.wmflabs.org/scholia/topic/Q183425) \| \| [v](https://en.wikipedia.org/wiki/Template:Digestive_system_and_abdomen_symptoms_and_signs "Template:Digestive system and abdomen symptoms and signs") [t](https://en.wikipedia.org/wiki/Template_talk:Digestive_system_and_abdomen_symptoms_and_signs "Template talk:Digestive system and abdomen symptoms and signs") [e](https://en.wikipedia.org/wiki/Special:EditPage/Template:Digestive_system_and_abdomen_symptoms_and_signs "Special:EditPage/Template:Digestive system and abdomen symptoms and signs")[Signs and symptoms](https://en.wikipedia.org/wiki/Signs_and_symptoms "Signs and symptoms") relating to the [human digestive system](https://en.wikipedia.org/wiki/Human_digestive_system "Human digestive system"), including the [abdomen](https://en.wikipedia.org/wiki/Abdomen "Abdomen") and [eating disorders](https://en.wikipedia.org/wiki/Eating_disorder "Eating disorder") that are associated \| \| \|---\|---\| \| [Gastrointestinal tract](https://en.wikipedia.org/wiki/Gastrointestinal_tract "Gastrointestinal tract") \| [Nausea](https://en.wikipedia.org/wiki/Nausea "Nausea") [Vomiting](https://en.wikipedia.org/wiki/Vomiting "Vomiting") [Heartburn](https://en.wikipedia.org/wiki/Heartburn "Heartburn") [Aerophagia](https://en.wikipedia.org/wiki/Aerophagia "Aerophagia") [Dysphagia](https://en.wikipedia.org/wiki/Dysphagia "Dysphagia") [oropharyngeal](https://en.wikipedia.org/wiki/Oropharyngeal_dysphagia "Oropharyngeal dysphagia") [esophageal](https://en.wikipedia.org/wiki/Esophageal_dysphagia "Esophageal dysphagia") [Odynophagia](https://en.wikipedia.org/wiki/Odynophagia "Odynophagia") [Bad breath](https://en.wikipedia.org/wiki/Bad_breath "Bad breath") [Xerostomia](https://en.wikipedia.org/wiki/Xerostomia "Xerostomia") [Hypersalivation](https://en.wikipedia.org/wiki/Hypersalivation "Hypersalivation") [Burping](https://en.wikipedia.org/wiki/Burping "Burping") [Goodsall's rule](https://en.wikipedia.org/wiki/Goodsall%27s_rule "Goodsall's rule") [Chilaiditi syndrome](https://en.wikipedia.org/wiki/Chilaiditi_syndrome "Chilaiditi syndrome") [Dance's sign](https://en.wikipedia.org/wiki/Dance%27s_sign "Dance's sign") [Aaron's sign](https://en.wikipedia.org/wiki/Aaron%27s_sign "Aaron's sign") [Arapov's sign](https://en.wikipedia.org/wiki/Arapov%27s_contracture "Arapov's contracture") [Markle's sign](https://en.wikipedia.org/wiki/Markle%27s_sign "Markle's sign") [McBurney's point](https://en.wikipedia.org/wiki/McBurney%27s_point "McBurney's point") [Sherren's triangle](https://en.wikipedia.org/wiki/Sherren%27s_triangle "Sherren's triangle") [Radiologic signs](https://en.wikipedia.org/wiki/Radiologic_sign "Radiologic sign"): [Hampton's line](https://en.wikipedia.org/wiki/Hampton%27s_line "Hampton's line") [Klemm's sign](https://en.wikipedia.org/wiki/Klemm%27s_sign "Klemm's sign") \| \| Accessory \| [liver](https://en.wikipedia.org/wiki/Liver "Liver"): [Councilman body](https://en.wikipedia.org/wiki/Councilman_body "Councilman body") [Mallory body](https://en.wikipedia.org/wiki/Mallory_body "Mallory body") biliary: [Boas' sign](https://en.wikipedia.org/wiki/Boas%27_sign "Boas' sign") [Courvoisier's law](https://en.wikipedia.org/wiki/Courvoisier%27s_law "Courvoisier's law") [Charcot's cholangitis triad](https://en.wikipedia.org/wiki/Charcot%27s_cholangitis_triad "Charcot's cholangitis triad")/[Reynolds' pentad](https://en.wikipedia.org/wiki/Reynolds%27_pentad "Reynolds' pentad") [cholecystitis](https://en.wikipedia.org/wiki/Cholecystitis "Cholecystitis") ([Murphy's sign](https://en.wikipedia.org/wiki/Murphy%27s_sign "Murphy's sign") [Lépine's sign](https://en.wikipedia.org/wiki/L%C3%A9pine%27s_sign "Lépine's sign") [Mirizzi's syndrome](https://en.wikipedia.org/wiki/Mirizzi%27s_syndrome "Mirizzi's syndrome")) [Nardi test](https://en.wikipedia.org/wiki/Nardi_test "Nardi test") \| \| [Defecation](https://en.wikipedia.org/wiki/Defecation "Defecation") \| [Flatulence](https://en.wikipedia.org/wiki/Flatulence "Flatulence") [Fecal incontinence](https://en.wikipedia.org/wiki/Fecal_incontinence "Fecal incontinence") and [encopresis](https://en.wikipedia.org/wiki/Encopresis "Encopresis") [Fecal urgency](https://en.wikipedia.org/wiki/Fecal_urgency "Fecal urgency") [Fecal occult blood](https://en.wikipedia.org/wiki/Fecal_occult_blood "Fecal occult blood") [Rectal tenesmus](https://en.wikipedia.org/wiki/Rectal_tenesmus "Rectal tenesmus") [Constipation](https://en.wikipedia.org/wiki/Constipation "Constipation") [Obstructed defecation](https://en.wikipedia.org/wiki/Obstructed_defecation "Obstructed defecation") [Diarrhea](https://en.wikipedia.org/wiki/Diarrhea "Diarrhea") [Rectal discharge](https://en.wikipedia.org/wiki/Rectal_discharge "Rectal discharge") \| \| Abdomen \| \| \| \| \| \| Pain \| [Abdominal pain]() [Acute abdomen](https://en.wikipedia.org/wiki/Acute_abdomen "Acute abdomen") [Colic](https://en.wikipedia.org/wiki/Colic "Colic") [Baby colic](https://en.wikipedia.org/wiki/Baby_colic "Baby colic") [Abdominal guarding](https://en.wikipedia.org/wiki/Abdominal_guarding "Abdominal guarding") [Blumberg's sign](https://en.wikipedia.org/wiki/Blumberg%27s_sign "Blumberg's sign") \| \| Distension \| [Abdominal distension](https://en.wikipedia.org/wiki/Abdominal_distension "Abdominal distension") [Bloating](https://en.wikipedia.org/wiki/Bloating "Bloating") [Ascites](https://en.wikipedia.org/wiki/Ascites "Ascites") [Tympany](https://en.wikipedia.org/wiki/Tympany "Tympany") [Shifting dullness](https://en.wikipedia.org/wiki/Shifting_dullness "Shifting dullness") [Fluid wave test](https://en.wikipedia.org/wiki/Fluid_wave_test "Fluid wave test") \| \| Masses \| [Abdominal mass](https://en.wikipedia.org/wiki/Abdominal_mass "Abdominal mass") [Hepatosplenomegaly](https://en.wikipedia.org/wiki/Hepatosplenomegaly "Hepatosplenomegaly") [Hepatomegaly](https://en.wikipedia.org/wiki/Hepatomegaly "Hepatomegaly") [Splenomegaly](https://en.wikipedia.org/wiki/Splenomegaly "Splenomegaly") \| \| Other \| [Jaundice](https://en.wikipedia.org/wiki/Jaundice "Jaundice") [Mallet-Guy's sign](https://en.wikipedia.org/wiki/Mallet-Guy%27s_sign "Mallet-Guy's sign") [Puddle sign](https://en.wikipedia.org/wiki/Puddle_sign "Puddle sign") [Ballance's sign](https://en.wikipedia.org/wiki/Ballance%27s_sign "Ballance's sign") [Aortic insufficiency](https://en.wikipedia.org/wiki/Aortic_insufficiency "Aortic insufficiency") [Castell's sign](https://en.wikipedia.org/wiki/Castell%27s_sign "Castell's sign") [Kehr's sign](https://en.wikipedia.org/wiki/Kehr%27s_sign "Kehr's sign") [Cullen's sign](https://en.wikipedia.org/wiki/Cullen%27s_sign "Cullen's sign") [Grey Turner's sign](https://en.wikipedia.org/wiki/Grey_Turner%27s_sign "Grey Turner's sign") \| \| [Hernia](https://en.wikipedia.org/wiki/Hernia "Hernia") \| [Howship–Romberg sign](https://en.wikipedia.org/wiki/Howship%E2%80%93Romberg_sign "Howship–Romberg sign") [Hannington-Kiff sign](https://en.wikipedia.org/wiki/Hannington-Kiff_sign "Hannington-Kiff sign") \| \| Other \| [Psoas sign](https://en.wikipedia.org/wiki/Psoas_sign "Psoas sign") [Obturator sign](https://en.wikipedia.org/wiki/Obturator_sign "Obturator sign") [Rovsing's sign](https://en.wikipedia.org/wiki/Rovsing%27s_sign "Rovsing's sign") [Hamburger sign](https://en.wikipedia.org/wiki/Hamburger_sign "Hamburger sign") [Heel tap sign](https://en.wikipedia.org/wiki/Heel_tap_sign "Heel tap sign") [Aure-Rozanova's sign](https://en.wikipedia.org/wiki/Aure-Rozanova%27s_sign "Aure-Rozanova's sign") [Dunphy's sign](https://en.wikipedia.org/wiki/Dunphy%27s_sign "Dunphy's sign") [Alder's sign](https://en.wikipedia.org/wiki/Alder%27s_sign "Alder's sign") [Lockwood's sign](https://en.wikipedia.org/wiki/Lockwood%27s_sign "Lockwood's sign") [Rosenstein's sign](https://en.wikipedia.org/wiki/Rosenstein%27s_sign "Rosenstein's sign") [Cupola sign](https://en.wikipedia.org/wiki/Cupola_sign "Cupola sign") [Fothergill's sign](https://en.wikipedia.org/wiki/Fothergill%27s_sign "Fothergill's sign") [Carnett's sign](https://en.wikipedia.org/wiki/Carnett%27s_sign "Carnett's sign") [Massouh's sign](https://en.wikipedia.org/wiki/Massouh%27s_sign "Massouh's sign") [Sister Mary Joseph nodule](https://en.wikipedia.org/wiki/Sister_Mary_Joseph_nodule "Sister Mary Joseph nodule") [Blumer's shelf](https://en.wikipedia.org/wiki/Blumer%27s_shelf "Blumer's shelf") \| \| Eating disorders \| [Anorexia](https://en.wikipedia.org/wiki/Anorexia_\(symptom\) "Anorexia (symptom)") [Anorexia nervosa](https://en.wikipedia.org/wiki/Anorexia_nervosa "Anorexia nervosa") [Bulimia nervosa](https://en.wikipedia.org/wiki/Bulimia_nervosa "Bulimia nervosa") [Binge eating disorder](https://en.wikipedia.org/wiki/Binge_eating_disorder "Binge eating disorder") [A/RFID](https://en.wikipedia.org/wiki/Avoidant/restrictive_food_intake_disorder "Avoidant/restrictive food intake disorder") [Pica](https://en.wikipedia.org/wiki/Pica_\(disorder\) "Pica (disorder)") [Trichophagia](https://en.wikipedia.org/wiki/Trichophagia "Trichophagia") [Pagophagia](https://en.wikipedia.org/wiki/Pagophagia "Pagophagia") [Geophagia](https://en.wikipedia.org/wiki/Geophagia "Geophagia") \| \| \| \| \|---\|---\| \| [Authority control databases](https://en.wikipedia.org/wiki/Help:Authority_control "Help:Authority control"): National [![Edit this at Wikidata](https://upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/20px-OOjs_UI_icon_edit-ltr-progressive.svg.png)](https://www.wikidata.org/wiki/Q183425#identifiers "Edit this at Wikidata") \| [Japan](https://id.ndl.go.jp/auth/ndlna/00563653) [Czech Republic](https://aleph.nkp.cz/F/?func=find-c&local_base=aut&ccl_term=ica=ph207456&CON_LNG=ENG) [Israel](https://www.nli.org.il/en/authorities/987007292974105171) \| ![](https://en.wikipedia.org/wiki/Special:CentralAutoLogin/start?useformat=desktop&type=1x1&usesul3=1) Retrieved from 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Readable Markdown	From Wikipedia, the free encyclopedia "Stomach ache" redirects here. For the 2014 album by Frank Iero, see [Stomachaches (album)](https://en.wikipedia.org/wiki/Stomachaches_\(album\) "Stomachaches (album)"). \| Abdominal pain \| \| \|---\|---\| \| Other names \| Stomach ache, tummy ache, belly ache, belly pain, gastralgia, stomach pain \| \| [![](https://upload.wikimedia.org/wikipedia/commons/thumb/f/f0/Gray1220.svg/250px-Gray1220.svg.png)](https://en.wikipedia.org/wiki/File:Gray1220.svg) \| \| \| Abdominal pain can be characterized by the region it affects. \| \| \| [Specialty](https://en.wikipedia.org/wiki/Medical_specialty "Medical specialty") \| [Gastroenterology](https://en.wikipedia.org/wiki/Gastroenterology "Gastroenterology"), [general surgery](https://en.wikipedia.org/wiki/General_surgery "General surgery") \| \| [Complications](https://en.wikipedia.org/wiki/Complication_\(medicine\) "Complication (medicine)") \| [Anorexia](https://en.wikipedia.org/wiki/Anorexia_\(symptom\) "Anorexia (symptom)") \| \| [Causes](https://en.wikipedia.org/wiki/Cause_\(medicine\) "Cause (medicine)") \| Serious: [Appendicitis](https://en.wikipedia.org/wiki/Appendicitis "Appendicitis"), perforated [stomach ulcer](https://en.wikipedia.org/wiki/Stomach_ulcer "Stomach ulcer"), [pancreatitis](https://en.wikipedia.org/wiki/Pancreatitis "Pancreatitis"), ruptured [diverticulitis](https://en.wikipedia.org/wiki/Diverticulitis "Diverticulitis"), [ovarian torsion](https://en.wikipedia.org/wiki/Ovarian_torsion "Ovarian torsion"), [volvulus](https://en.wikipedia.org/wiki/Volvulus "Volvulus"), ruptured [aortic aneurysm](https://en.wikipedia.org/wiki/Aortic_aneurysm "Aortic aneurysm"), [lacerated spleen](https://en.wikipedia.org/wiki/Lacerated_spleen "Lacerated spleen") or liver, [ischemic colitis](https://en.wikipedia.org/wiki/Ischemic_colitis "Ischemic colitis"), [ischaemic myocardial conditions](https://en.wikipedia.org/w/index.php?title=Ischaemic_myocardial_conditions&action=edit&redlink=1 "Ischaemic myocardial conditions (page does not exist)")[\[1\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Stat2018-1) Common: [Gastroenteritis](https://en.wikipedia.org/wiki/Gastroenteritis "Gastroenteritis"), [irritable bowel syndrome](https://en.wikipedia.org/wiki/Irritable_bowel_syndrome "Irritable bowel syndrome")[\[2\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Vin2014-2) \| Abdominal pain, also known as a stomach ache, is a [symptom](https://en.wikipedia.org/wiki/Symptom "Symptom") associated with both non-serious and serious medical issues. Since the abdomen contains most of the body's vital organs, it can be an indicator of a wide variety of diseases. Given that, approaching the examination of a person and planning of a [differential diagnosis](https://en.wikipedia.org/wiki/Differential_diagnosis "Differential diagnosis") is extremely important.[\[3\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Hopcroft2020-3) Common causes of [pain](https://en.wikipedia.org/wiki/Pain "Pain") in the [abdomen](https://en.wikipedia.org/wiki/Abdomen "Abdomen") include [gastroenteritis](https://en.wikipedia.org/wiki/Gastroenteritis "Gastroenteritis") and [irritable bowel syndrome](https://en.wikipedia.org/wiki/Irritable_bowel_syndrome "Irritable bowel syndrome").[\[3\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Hopcroft2020-3) About 15% of people have a more serious underlying condition such as [appendicitis](https://en.wikipedia.org/wiki/Appendicitis "Appendicitis"), leaking or ruptured [abdominal aortic aneurysm](https://en.wikipedia.org/wiki/Abdominal_aortic_aneurysm "Abdominal aortic aneurysm"), [diverticulitis](https://en.wikipedia.org/wiki/Diverticulitis "Diverticulitis"), or [ectopic pregnancy](https://en.wikipedia.org/wiki/Ectopic_pregnancy "Ectopic pregnancy").[\[2\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Vin2014-2) In a third of cases, the exact cause is unclear.[\[2\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Vin2014-2) The onset of abdominal pain can be abrupt, quick, or gradual. Sudden onset pain happens in a split second. Rapidly onset pain starts mild and gets worse over the next few minutes. Pain that gradually intensifies only after several hours or even days has passed is referred to as gradual onset pain.[\[4\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Sherman_1990_r770-4) One can describe abdominal pain as either continuous or sporadic and as [cramping](https://en.wikipedia.org/wiki/Cramp "Cramp"), dull, or aching. The characteristic of cramping abdominal pain is that it comes in brief waves, builds to a peak, and then abruptly stops for a period during which there is no more pain. The pain flares up and off periodically. The most common cause of persistent dull or aching abdominal pain is edema or distention of the wall of a hollow viscus. A dull or aching pain may also be felt due to a stretch in the liver and spleen capsules.[\[4\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Sherman_1990_r770-4) The most frequent reasons for abdominal pain are [gastroenteritis](https://en.wikipedia.org/wiki/Gastroenteritis "Gastroenteritis") (13%), [irritable bowel syndrome](https://en.wikipedia.org/wiki/Irritable_bowel_syndrome "Irritable bowel syndrome") (8%), urinary tract problems (5%), [inflammation of the stomach](https://en.wikipedia.org/wiki/Gastritis "Gastritis") (5%) and [constipation](https://en.wikipedia.org/wiki/Constipation "Constipation") (5%). In about 30% of cases, the cause is not determined. About 10% of cases have a more serious cause including gallbladder ([gallstones](https://en.wikipedia.org/wiki/Gallstone "Gallstone") or [biliary dyskinesia](https://en.wikipedia.org/wiki/Biliary_dyskinesia "Biliary dyskinesia")) or [pancreas](https://en.wikipedia.org/wiki/Pancreas "Pancreas") problems (4%), [diverticulitis](https://en.wikipedia.org/wiki/Diverticulitis "Diverticulitis") (3%), [appendicitis](https://en.wikipedia.org/wiki/Appendicitis "Appendicitis") (2%) and [cancer](https://en.wikipedia.org/wiki/Cancer "Cancer") (1%).[\[2\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Vin2014-2) More common in those who are older, [ischemic colitis](https://en.wikipedia.org/wiki/Ischemic_colitis "Ischemic colitis"),[\[5\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-5) [mesenteric ischemia](https://en.wikipedia.org/wiki/Mesenteric_ischemia "Mesenteric ischemia"), and [abdominal aortic aneurysms](https://en.wikipedia.org/wiki/Abdominal_aortic_aneurysm "Abdominal aortic aneurysm") are other serious causes.[\[6\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Spangler_2014-6) [Acute abdomen](https://en.wikipedia.org/wiki/Acute_abdomen "Acute abdomen") is a condition where there is a sudden onset of severe abdominal pain requiring immediate recognition and management of the underlying cause.[\[7\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-aa-7) The underlying cause may involve infection, [inflammation](https://en.wikipedia.org/wiki/Inflammation "Inflammation"), [vascular occlusion](https://en.wikipedia.org/wiki/Vascular_occlusion "Vascular occlusion") or bowel obstruction.[\[7\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-aa-7) The pain may elicit [nausea](https://en.wikipedia.org/wiki/Nausea "Nausea") and [vomiting](https://en.wikipedia.org/wiki/Vomiting "Vomiting"), [abdominal distention](https://en.wikipedia.org/wiki/Abdominal_distention "Abdominal distention"), [fever](https://en.wikipedia.org/wiki/Fever "Fever") and signs of [shock](https://en.wikipedia.org/wiki/Shock_\(circulatory\) "Shock (circulatory)").[\[7\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-aa-7) A common condition associated with acute abdominal pain is [appendicitis](https://en.wikipedia.org/wiki/Appendicitis "Appendicitis").[\[8\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-8) Here is a list of acute abdomen causes: \| \| \| \|---\|---\| \| Surgical causes \[[edit](https://en.wikipedia.org/w/index.php?title=Abdominal_pain&action=edit&section=4 "Edit section: Surgical causes")\] \| Source:[\[7\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-aa-7) Inflammatory \[[edit](https://en.wikipedia.org/w/index.php?title=Abdominal_pain&action=edit&section=5 "Edit section: Inflammatory")\] Infections such as [appendicitis](https://en.wikipedia.org/wiki/Appendicitis "Appendicitis"), [cholecystitis](https://en.wikipedia.org/wiki/Cholecystitis "Cholecystitis"), [pancreatitis](https://en.wikipedia.org/wiki/Pancreatitis "Pancreatitis"), [pyelonephritis](https://en.wikipedia.org/wiki/Pyelonephritis "Pyelonephritis"), [Peritonitis](https://en.wikipedia.org/wiki/Peritonitis "Peritonitis"), [pelvic inflammatory disease](https://en.wikipedia.org/wiki/Pelvic_inflammatory_disease "Pelvic inflammatory disease"), [hepatitis](https://en.wikipedia.org/wiki/Hepatitis "Hepatitis"), [mesenteric adenitis](https://en.wikipedia.org/wiki/Mesenteric_adenitis "Mesenteric adenitis"), or a subdiaphragmatic [abscess](https://en.wikipedia.org/wiki/Abscess "Abscess"). [Perforation](https://en.wikipedia.org/wiki/Gastrointestinal_perforation "Gastrointestinal perforation") of a [peptic ulcer](https://en.wikipedia.org/wiki/Peptic_ulcer "Peptic ulcer"), a [diverticulum](https://en.wikipedia.org/wiki/Diverticulitis "Diverticulitis"), or the [caecum](https://en.wikipedia.org/wiki/Caecum "Caecum"). Complications of [inflammatory bowel disease](https://en.wikipedia.org/wiki/Inflammatory_bowel_disease "Inflammatory bowel disease"), such as [Crohn's disease](https://en.wikipedia.org/wiki/Crohn%27s_disease "Crohn's disease") or [ulcerative colitis](https://en.wikipedia.org/wiki/Ulcerative_colitis "Ulcerative colitis"). Mechanical \[[edit](https://en.wikipedia.org/w/index.php?title=Abdominal_pain&action=edit&section=6 "Edit section: Mechanical")\] [Small bowel](https://en.wikipedia.org/wiki/Small_bowel "Small bowel") [obstruction](https://en.wikipedia.org/wiki/Bowel_obstruction "Bowel obstruction") secondary to adhesions caused by previous surgeries, [intussusception](https://en.wikipedia.org/wiki/Intussusception_\(medical_disorder\) "Intussusception (medical disorder)"), [hernias](https://en.wikipedia.org/wiki/Hernia "Hernia"), benign or malignant [neoplasms](https://en.wikipedia.org/wiki/Neoplasia "Neoplasia"). [Large bowel](https://en.wikipedia.org/wiki/Large_bowel "Large bowel") [obstruction](https://en.wikipedia.org/wiki/Bowel_obstruction "Bowel obstruction") caused by [colorectal cancer](https://en.wikipedia.org/wiki/Colorectal_cancer "Colorectal cancer"), [inflammatory bowel disease](https://en.wikipedia.org/wiki/Inflammatory_bowel_disease "Inflammatory bowel disease"), [volvulus](https://en.wikipedia.org/wiki/Volvulus "Volvulus"), [fecal impaction](https://en.wikipedia.org/wiki/Fecal_impaction "Fecal impaction"), or [hernia](https://en.wikipedia.org/wiki/Hernia "Hernia"). Vascular \[[edit](https://en.wikipedia.org/w/index.php?title=Abdominal_pain&action=edit&section=7 "Edit section: Vascular")\] occlusive [intestinal ischemia](https://en.wikipedia.org/wiki/Intestinal_ischemia "Intestinal ischemia"), usually caused by [thromboembolism](https://en.wikipedia.org/wiki/Thromboembolism "Thromboembolism") of the [superior Mesenteric artery.](https://en.wikipedia.org/wiki/Superior_mesenteric_artery "Superior mesenteric artery") [Referred pain](https://en.wikipedia.org/wiki/Referred_pain "Referred pain") \[[edit](https://en.wikipedia.org/w/index.php?title=Abdominal_pain&action=edit&section=8 "Edit section: Referred pain")\] Source:[\[9\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-9) Viscero-visceral referral: happens when one organ with afferent nerves close to another organ is sensitized or inflamed (in this case any of the abdominal viscera)[\[10\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-10) Viscero-somatic referral: any pain in the viscera that causes pain in the muscle, bone, and skin (of the abdomen in case of abdominal pain) Somatic-visceral referral: pain in the skin, muscles, and bone that causes referred pain in the viscera (of the abdomen such as the stomach, kidneys, bladder, etc.) \| \| Medical causes \[[edit](https://en.wikipedia.org/w/index.php?title=Abdominal_pain&action=edit&section=9 "Edit section: Medical causes")\] \| Source:[\[7\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-aa-7)[Acute pancreatitis](https://en.wikipedia.org/wiki/Acute_pancreatitis "Acute pancreatitis").[Sickle cell anemia](https://en.wikipedia.org/wiki/Sickle_cell_disease "Sickle cell disease").[Diabetic ketoacidosis](https://en.wikipedia.org/wiki/Diabetic_ketoacidosis "Diabetic ketoacidosis") (DKA).[Adrenal crisis](https://en.wikipedia.org/wiki/Adrenal_crisis "Adrenal crisis").[Pyelonephritis](https://en.wikipedia.org/wiki/Pyelonephritis "Pyelonephritis").[Lead poisoning](https://en.wikipedia.org/wiki/Lead_poisoning "Lead poisoning").[Familial Mediterranean fever](https://en.wikipedia.org/wiki/Familial_Mediterranean_fever "Familial Mediterranean fever") (FMF). \| \| Gynecological causes \[[edit](https://en.wikipedia.org/w/index.php?title=Abdominal_pain&action=edit&section=10 "Edit section: Gynecological causes")\] \| Source:[\[11\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-11)[Pelvic inflammatory disease](https://en.wikipedia.org/wiki/Pelvic_inflammatory_disease "Pelvic inflammatory disease") (PID) and abscess.[Ectopic pregnancy](https://en.wikipedia.org/wiki/Ectopic_pregnancy "Ectopic pregnancy").Hemorrhagic [ovarian cyst](https://en.wikipedia.org/wiki/Ovarian_cyst "Ovarian cyst").Adnexal or [ovarian torsion](https://en.wikipedia.org/wiki/Ovarian_torsion "Ovarian torsion"). \| A more extensive list includes the following:\[[citation needed](https://en.wikipedia.org/wiki/Wikipedia:Citation_needed "Wikipedia:Citation needed")\] - Gastrointestinal - GI tract - Inflammatory: [gastroenteritis](https://en.wikipedia.org/wiki/Gastroenteritis "Gastroenteritis"), [appendicitis](https://en.wikipedia.org/wiki/Appendicitis "Appendicitis"), [gastritis](https://en.wikipedia.org/wiki/Gastritis "Gastritis"), [esophagitis](https://en.wikipedia.org/wiki/Esophagitis "Esophagitis"), [diverticulitis](https://en.wikipedia.org/wiki/Diverticulitis "Diverticulitis"), [Crohn's disease](https://en.wikipedia.org/wiki/Crohn%27s_disease "Crohn's disease"), [ulcerative colitis](https://en.wikipedia.org/wiki/Ulcerative_colitis "Ulcerative colitis"), [microscopic colitis](https://en.wikipedia.org/wiki/Microscopic_colitis "Microscopic colitis") - Obstruction: [hernia](https://en.wikipedia.org/wiki/Hernia "Hernia"), [intussusception](https://en.wikipedia.org/wiki/Intussusception_\(medical_disorder\) "Intussusception (medical disorder)"), [volvulus](https://en.wikipedia.org/wiki/Volvulus "Volvulus"), post-surgical [adhesions](https://en.wikipedia.org/wiki/Adhesions "Adhesions"), [tumors](https://en.wikipedia.org/wiki/Tumor "Tumor"), severe [constipation](https://en.wikipedia.org/wiki/Constipation "Constipation"), [hemorrhoids](https://en.wikipedia.org/wiki/Hemorrhoids "Hemorrhoids") - Vascular: [embolism](https://en.wikipedia.org/wiki/Embolism "Embolism"), [thrombosis](https://en.wikipedia.org/wiki/Thrombosis "Thrombosis"), [hemorrhage](https://en.wikipedia.org/wiki/Hemorrhage "Hemorrhage"), [sickle cell disease](https://en.wikipedia.org/wiki/Sickle_cell_disease "Sickle cell disease"), [abdominal angina](https://en.wikipedia.org/wiki/Abdominal_angina "Abdominal angina"), blood vessel compression (such as celiac artery compression syndrome), [superior mesenteric artery syndrome](https://en.wikipedia.org/wiki/Superior_mesenteric_artery_syndrome "Superior mesenteric artery syndrome"), [postural orthostatic tachycardia syndrome](https://en.wikipedia.org/wiki/Postural_orthostatic_tachycardia_syndrome "Postural orthostatic tachycardia syndrome") - [Digestive](https://en.wikipedia.org/wiki/Digestion "Digestion"): [peptic ulcer](https://en.wikipedia.org/wiki/Peptic_ulcer "Peptic ulcer"), [lactose intolerance](https://en.wikipedia.org/wiki/Lactose_intolerance "Lactose intolerance"), [celiac disease](https://en.wikipedia.org/wiki/Coeliac_disease "Coeliac disease"), [food allergies](https://en.wikipedia.org/wiki/Food_allergies "Food allergies"), [indigestion](https://en.wikipedia.org/wiki/Indigestion "Indigestion") - Glands - Bile system - Inflammatory: [cholecystitis](https://en.wikipedia.org/wiki/Cholecystitis "Cholecystitis"), [cholangitis](https://en.wikipedia.org/wiki/Cholangitis "Cholangitis") - Obstruction: [cholelithiasis](https://en.wikipedia.org/wiki/Cholelithiasis "Cholelithiasis") - Liver - Inflammatory: [hepatitis](https://en.wikipedia.org/wiki/Hepatitis "Hepatitis"), [liver abscess](https://en.wikipedia.org/wiki/Liver_abscess "Liver abscess") - Pancreatic - Inflammatory: [pancreatitis](https://en.wikipedia.org/wiki/Pancreatitis "Pancreatitis") - Renal and urological - Inflammation: [pyelonephritis](https://en.wikipedia.org/wiki/Pyelonephritis "Pyelonephritis"), [bladder infection](https://en.wikipedia.org/wiki/Cystitis "Cystitis") - Obstruction: [kidney stones](https://en.wikipedia.org/wiki/Nephrolithiasis "Nephrolithiasis"), [urolithiasis](https://en.wikipedia.org/wiki/Urolithiasis "Urolithiasis"), [urinary retention](https://en.wikipedia.org/wiki/Urinary_retention "Urinary retention") - Vascular: [left renal vein entrapment](https://en.wikipedia.org/wiki/Left_renal_vein_entrapment "Left renal vein entrapment") - Gynaecological or obstetric - Inflammatory: [pelvic inflammatory disease](https://en.wikipedia.org/wiki/Pelvic_inflammatory_disease "Pelvic inflammatory disease") - Mechanical: [ovarian torsion](https://en.wikipedia.org/wiki/Ovarian_torsion "Ovarian torsion") - Endocrinological: [menstruation](https://en.wikipedia.org/wiki/Menstruation "Menstruation"), [Mittelschmerz](https://en.wikipedia.org/wiki/Mittelschmerz "Mittelschmerz") - Tumors: [endometriosis](https://en.wikipedia.org/wiki/Endometriosis "Endometriosis"), [fibroids](https://en.wikipedia.org/wiki/Fibroma "Fibroma"), [ovarian cyst](https://en.wikipedia.org/wiki/Ovarian_cyst "Ovarian cyst"), [ovarian cancer](https://en.wikipedia.org/wiki/Ovarian_cancer "Ovarian cancer") - Pregnancy: ruptured [ectopic pregnancy](https://en.wikipedia.org/wiki/Ectopic_pregnancy "Ectopic pregnancy"), [threatened abortion](https://en.wikipedia.org/wiki/Threatened_abortion "Threatened abortion") - [Abdominal wall](https://en.wikipedia.org/wiki/Abdominal_wall "Abdominal wall") - muscle strain or trauma - muscular infection - [neurogenic](https://en.wikipedia.org/wiki/Neurogenic "Neurogenic") pain: [herpes zoster](https://en.wikipedia.org/wiki/Herpes_zoster "Herpes zoster"), [radiculitis](https://en.wikipedia.org/wiki/Radiculitis "Radiculitis") in [Lyme disease](https://en.wikipedia.org/wiki/Lyme_disease "Lyme disease"), [abdominal cutaneous nerve entrapment syndrome](https://en.wikipedia.org/wiki/Anterior_cutaneous_nerve_entrapment_syndrome "Anterior cutaneous nerve entrapment syndrome") (ACNES), [tabes dorsalis](https://en.wikipedia.org/wiki/Tabes_dorsalis "Tabes dorsalis") - [Referred pain](https://en.wikipedia.org/wiki/Referred_pain "Referred pain") - from the [thorax](https://en.wikipedia.org/wiki/Thorax "Thorax"): [pneumonia](https://en.wikipedia.org/wiki/Pneumonia "Pneumonia"), [pulmonary embolism](https://en.wikipedia.org/wiki/Pulmonary_embolism "Pulmonary embolism"), [ischemic heart disease](https://en.wikipedia.org/wiki/Ischemic_heart_disease "Ischemic heart disease"), [pericarditis](https://en.wikipedia.org/wiki/Pericarditis "Pericarditis") - from the [spine](https://en.wikipedia.org/wiki/Vertebral_column "Vertebral column"): [radiculitis](https://en.wikipedia.org/wiki/Radiculitis "Radiculitis") - from the [genitals](https://en.wikipedia.org/wiki/Genitals "Genitals"): [testicular torsion](https://en.wikipedia.org/wiki/Testicular_torsion "Testicular torsion") - [Metabolic disturbance](https://en.wikipedia.org/wiki/Metabolic_disturbance "Metabolic disturbance") - [uremia](https://en.wikipedia.org/wiki/Uremia "Uremia"), [diabetic ketoacidosis](https://en.wikipedia.org/wiki/Diabetic_ketoacidosis "Diabetic ketoacidosis"), [porphyria](https://en.wikipedia.org/wiki/Porphyria "Porphyria"), [C1-esterase inhibitor deficiency](https://en.wikipedia.org/wiki/C1-esterase_inhibitor_deficiency "C1-esterase inhibitor deficiency"), adrenal insufficiency, [lead poisoning](https://en.wikipedia.org/wiki/Lead_poisoning "Lead poisoning"), [black widow spider](https://en.wikipedia.org/wiki/Latrodectus "Latrodectus") bite, [narcotic](https://en.wikipedia.org/wiki/Narcotic "Narcotic") [withdrawal](https://en.wikipedia.org/wiki/Drug_withdrawal "Drug withdrawal") - Blood vessels - [aortic dissection](https://en.wikipedia.org/wiki/Aortic_dissection "Aortic dissection"), [abdominal aortic aneurysm](https://en.wikipedia.org/wiki/Abdominal_aortic_aneurysm "Abdominal aortic aneurysm") - Immune system - [sarcoidosis](https://en.wikipedia.org/wiki/Sarcoidosis "Sarcoidosis") - [vasculitis](https://en.wikipedia.org/wiki/Vasculitis "Vasculitis") - [familial Mediterranean fever](https://en.wikipedia.org/wiki/Familial_Mediterranean_fever "Familial Mediterranean fever") - Idiopathic - [irritable bowel syndrome](https://en.wikipedia.org/wiki/Irritable_bowel_syndrome "Irritable bowel syndrome") (IBS) (affecting up to 20% of the population, IBS is the most common cause of recurrent and intermittent abdominal pain) The location of abdominal pain can provide information about what may be causing the pain. The abdomen can be divided into four regions called quadrants. Locations and associated conditions include:[\[12\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-12)[\[13\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-13) - Diffuse - [Peritonitis](https://en.wikipedia.org/wiki/Peritonitis "Peritonitis") - Vascular: [mesenteric ischemia](https://en.wikipedia.org/wiki/Mesenteric_ischemia "Mesenteric ischemia"), [ischemic colitis](https://en.wikipedia.org/wiki/Ischemic_colitis "Ischemic colitis"), [Henoch-Schonlein purpura](https://en.wikipedia.org/wiki/Henoch%E2%80%93Sch%C3%B6nlein_purpura "Henoch–Schönlein purpura"), [sickle cell disease](https://en.wikipedia.org/wiki/Sickle_cell_disease "Sickle cell disease"), [systemic lupus erythematosus](https://en.wikipedia.org/wiki/Systemic_lupus_erythematosus "Systemic lupus erythematosus"), [polyarteritis nodosa](https://en.wikipedia.org/wiki/Polyarteritis_nodosa "Polyarteritis nodosa") - Small [bowel obstruction](https://en.wikipedia.org/wiki/Bowel_obstruction "Bowel obstruction") - [Irritable bowel syndrome](https://en.wikipedia.org/wiki/Irritable_bowel_syndrome "Irritable bowel syndrome") - [Metabolic disorders](https://en.wikipedia.org/wiki/Metabolic_disorder "Metabolic disorder"): [ketoacidosis](https://en.wikipedia.org/wiki/Ketoacidosis "Ketoacidosis"), [porphyria](https://en.wikipedia.org/wiki/Porphyria "Porphyria"), [familial Mediterranean fever](https://en.wikipedia.org/wiki/Familial_Mediterranean_fever "Familial Mediterranean fever"), [adrenal crisis](https://en.wikipedia.org/wiki/Adrenal_crisis "Adrenal crisis") - Epigastric - Heart: [myocardial infarction](https://en.wikipedia.org/wiki/Myocardial_infarction "Myocardial infarction"), [pericarditis](https://en.wikipedia.org/wiki/Pericarditis "Pericarditis") - Stomach: [gastritis](https://en.wikipedia.org/wiki/Gastritis "Gastritis"), [stomach ulcer](https://en.wikipedia.org/wiki/Stomach_ulcer "Stomach ulcer"), [stomach cancer](https://en.wikipedia.org/wiki/Stomach_cancer "Stomach cancer") - Pancreas: [pancreatitis](https://en.wikipedia.org/wiki/Pancreatitis "Pancreatitis"), [pancreatic cancer](https://en.wikipedia.org/wiki/Pancreatic_cancer "Pancreatic cancer") - Intestinal: [duodenal ulcer](https://en.wikipedia.org/wiki/Peptic_ulcer_disease "Peptic ulcer disease"), [diverticulitis](https://en.wikipedia.org/wiki/Diverticulitis "Diverticulitis"), [appendicitis](https://en.wikipedia.org/wiki/Appendicitis "Appendicitis") - Right upper quadrant - Liver: [hepatomegaly](https://en.wikipedia.org/wiki/Hepatomegaly "Hepatomegaly"), [fatty liver](https://en.wikipedia.org/wiki/Fatty_liver "Fatty liver"), [hepatitis](https://en.wikipedia.org/wiki/Hepatitis "Hepatitis"), [liver cancer](https://en.wikipedia.org/wiki/Liver_cancer "Liver cancer"), [abscess](https://en.wikipedia.org/wiki/Abscess "Abscess") - Gallbladder and biliary tract: [inflammation](https://en.wikipedia.org/wiki/Cholecystitis "Cholecystitis"), [gallstones](https://en.wikipedia.org/wiki/Gallstone "Gallstone"), [worm infection](https://en.wikipedia.org/wiki/Helminthiasis "Helminthiasis"), [cholangitis](https://en.wikipedia.org/wiki/Cholangitis "Cholangitis") - Colon: [bowel obstruction](https://en.wikipedia.org/wiki/Bowel_obstruction "Bowel obstruction"), functional disorders, [gas accumulation](https://en.wikipedia.org/wiki/Bloating "Bloating"), [spasm](https://en.wikipedia.org/wiki/Spasm "Spasm"), inflammation, [colon cancer](https://en.wikipedia.org/wiki/Colon_cancer "Colon cancer") - Other: [pneumonia](https://en.wikipedia.org/wiki/Pneumonia "Pneumonia"), [Fitz-Hugh-Curtis syndrome](https://en.wikipedia.org/wiki/Fitz-Hugh%E2%80%93Curtis_syndrome "Fitz-Hugh–Curtis syndrome") - Left upper quadrant - [Splenomegaly](https://en.wikipedia.org/wiki/Splenomegaly "Splenomegaly") - Colon: [bowel obstruction](https://en.wikipedia.org/wiki/Bowel_obstruction "Bowel obstruction"), functional disorders, gas accumulation, spasm, inflammation, colon cancer - Peri-umbilical (the area around the umbilicus, i.e., the belly button) - [Appendicitis](https://en.wikipedia.org/wiki/Appendicitis "Appendicitis") - [Pancreatitis](https://en.wikipedia.org/wiki/Pancreatitis "Pancreatitis") - [Inferior myocardial infarction](https://en.wikipedia.org/wiki/Myocardial_infarction "Myocardial infarction") - [Peptic ulcer](https://en.wikipedia.org/wiki/Peptic_ulcer_disease "Peptic ulcer disease") - [Diabetic ketoacidosis](https://en.wikipedia.org/wiki/Diabetic_ketoacidosis "Diabetic ketoacidosis") - Vascular: [aortic dissection](https://en.wikipedia.org/wiki/Aortic_dissection "Aortic dissection"), aortic rupture - Bowel: [mesenteric ischemia](https://en.wikipedia.org/wiki/Mesenteric_ischemia "Mesenteric ischemia"), [Celiac disease](https://en.wikipedia.org/wiki/Coeliac_disease "Coeliac disease"), inflammation, intestinal spasm, functional disorders, [small bowel obstruction](https://en.wikipedia.org/wiki/Bowel_obstruction "Bowel obstruction") - Lower abdominal pain - [Diarrhea](https://en.wikipedia.org/wiki/Diarrhea "Diarrhea") - [Colitis](https://en.wikipedia.org/wiki/Colitis "Colitis") - [Crohn's](https://en.wikipedia.org/wiki/Crohn%27s_disease "Crohn's disease") - [Dysentery](https://en.wikipedia.org/wiki/Dysentery "Dysentery") - [Hernia](https://en.wikipedia.org/wiki/Hernia "Hernia") - Right lower quadrant - Colon: [intussusception](https://en.wikipedia.org/wiki/Intussusception_\(medical_disorder\) "Intussusception (medical disorder)"), [bowel obstruction](https://en.wikipedia.org/wiki/Bowel_obstruction "Bowel obstruction"), [appendicitis](https://en.wikipedia.org/wiki/Appendicitis "Appendicitis") ([McBurney's point](https://en.wikipedia.org/wiki/McBurney%27s_point "McBurney's point")) - Renal: [kidney stone](https://en.wikipedia.org/wiki/Kidney_stone_disease "Kidney stone disease") (nephrolithiasis), [pyelonephritis](https://en.wikipedia.org/wiki/Pyelonephritis "Pyelonephritis") - Pelvic: [cystitis](https://en.wikipedia.org/wiki/Cystitis "Cystitis"), [bladder stone](https://en.wikipedia.org/wiki/Bladder_stone "Bladder stone"), [bladder cancer](https://en.wikipedia.org/wiki/Bladder_cancer "Bladder cancer"), [pelvic inflammatory disease](https://en.wikipedia.org/wiki/Pelvic_inflammatory_disease "Pelvic inflammatory disease"), pelvic pain syndrome - Gynecologic: [endometriosis](https://en.wikipedia.org/wiki/Endometriosis "Endometriosis"), intrauterine [pregnancy](https://en.wikipedia.org/wiki/Pregnancy "Pregnancy"), [ectopic pregnancy](https://en.wikipedia.org/wiki/Ectopic_pregnancy "Ectopic pregnancy"), [ovarian cyst](https://en.wikipedia.org/wiki/Ovarian_cyst "Ovarian cyst"), [ovarian torsion](https://en.wikipedia.org/wiki/Ovarian_torsion "Ovarian torsion"), fibroid ([leiomyoma](https://en.wikipedia.org/wiki/Leiomyoma "Leiomyoma")), [abscess](https://en.wikipedia.org/wiki/Abscess "Abscess"), [ovarian cancer](https://en.wikipedia.org/wiki/Ovarian_cancer "Ovarian cancer"), [endometrial cancer](https://en.wikipedia.org/wiki/Endometrial_cancer "Endometrial cancer") - Left lower quadrant - Bowel: [diverticulitis](https://en.wikipedia.org/wiki/Diverticulitis "Diverticulitis"), [sigmoid colon volvulus](https://en.wikipedia.org/wiki/Sigmoid_colon_volvulus "Sigmoid colon volvulus"), [bowel obstruction](https://en.wikipedia.org/wiki/Bowel_obstruction "Bowel obstruction"), gas accumulation, [Toxic megacolon](https://en.wikipedia.org/wiki/Toxic_megacolon "Toxic megacolon") - Right [low back pain](https://en.wikipedia.org/wiki/Low_back_pain "Low back pain") - Liver: [hepatomegaly](https://en.wikipedia.org/wiki/Hepatomegaly "Hepatomegaly") - Kidney: [kidney stone](https://en.wikipedia.org/wiki/Kidney_stone_disease "Kidney stone disease") (nephrolithiasis), complicated urinary tract infection - Left low back pain - Spleen - Kidney: [kidney stone](https://en.wikipedia.org/wiki/Kidney_stone_disease "Kidney stone disease") (nephrolithiasis), complicated urinary tract infection - Low back pain - Kidney pain ([kidney stone](https://en.wikipedia.org/wiki/Kidney_stone "Kidney stone"), [kidney cancer](https://en.wikipedia.org/wiki/Kidney_cancer "Kidney cancer"), [hydronephrosis](https://en.wikipedia.org/wiki/Hydronephrosis "Hydronephrosis")) - [Ureteral stone](https://en.wikipedia.org/wiki/Ureter#Ureteral_stones "Ureter") pain \| Region \| Blood supply[\[14\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Moore_2016-14) \| Innervation[\[15\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-15) \| Structures[\[14\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Moore_2016-14) \| \|---\|---\|---\|---\| \| [Foregut](https://en.wikipedia.org/wiki/Foregut "Foregut") \| [Celiac artery](https://en.wikipedia.org/wiki/Celiac_artery "Celiac artery") \| T5 - T9 \| [Pharynx](https://en.wikipedia.org/wiki/Pharynx "Pharynx") [Esophagus](https://en.wikipedia.org/wiki/Esophagus "Esophagus")[Lower respiratory tract](https://en.wikipedia.org/wiki/Respiratory_tract "Respiratory tract")[Stomach](https://en.wikipedia.org/wiki/Stomach "Stomach")Proximal [duodenum](https://en.wikipedia.org/wiki/Duodenum "Duodenum")[Liver](https://en.wikipedia.org/wiki/Liver "Liver")[Biliary tract](https://en.wikipedia.org/wiki/Biliary_tract "Biliary tract")[Gallbladder](https://en.wikipedia.org/wiki/Gallbladder "Gallbladder")[Pancreas](https://en.wikipedia.org/wiki/Pancreas "Pancreas") \| \| [Midgut](https://en.wikipedia.org/wiki/Midgut "Midgut") \| [Superior mesenteric artery](https://en.wikipedia.org/wiki/Superior_mesenteric_artery "Superior mesenteric artery") \| T10 – T12 \| Distal [duodenum](https://en.wikipedia.org/wiki/Duodenum "Duodenum") [Cecum](https://en.wikipedia.org/wiki/Cecum "Cecum")[Appendix](https://en.wikipedia.org/wiki/Appendix_\(anatomy\) "Appendix (anatomy)")[Ascending colon](https://en.wikipedia.org/wiki/Ascending_colon "Ascending colon")Proximal [transverse colon](https://en.wikipedia.org/wiki/Transverse_colon "Transverse colon") \| \| [Hindgut](https://en.wikipedia.org/wiki/Hindgut "Hindgut") \| [Inferior mesenteric artery](https://en.wikipedia.org/wiki/Inferior_mesenteric_artery "Inferior mesenteric artery") \| L1 – L3 \| Distal [transverse colon](https://en.wikipedia.org/wiki/Transverse_colon "Transverse colon") [Descending colon](https://en.wikipedia.org/wiki/Descending_colon "Descending colon")[Sigmoid colon](https://en.wikipedia.org/wiki/Sigmoid_colon "Sigmoid colon")[Rectum](https://en.wikipedia.org/wiki/Rectum "Rectum")Superior [anal canal](https://en.wikipedia.org/wiki/Anal_canal "Anal canal") \| Abdominal pain can be referred to as [visceral pain](https://en.wikipedia.org/wiki/Visceral_pain "Visceral pain") or [peritoneal](https://en.wikipedia.org/wiki/Peritoneum "Peritoneum") pain. The contents of the abdomen can be divided into the [foregut](https://en.wikipedia.org/wiki/Foregut "Foregut"), [midgut](https://en.wikipedia.org/wiki/Midgut "Midgut"), and [hindgut](https://en.wikipedia.org/wiki/Hindgut "Hindgut").[\[14\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Moore_2016-14) The [foregut](https://en.wikipedia.org/wiki/Foregut "Foregut") contains the [pharynx](https://en.wikipedia.org/wiki/Pharynx "Pharynx"), lower [respiratory tract](https://en.wikipedia.org/wiki/Respiratory_tract "Respiratory tract"), portions of the [esophagus](https://en.wikipedia.org/wiki/Esophagus "Esophagus"), [stomach](https://en.wikipedia.org/wiki/Stomach "Stomach"), portions of the [duodenum](https://en.wikipedia.org/wiki/Duodenum "Duodenum") (proximal), [liver](https://en.wikipedia.org/wiki/Liver "Liver"), [biliary tract](https://en.wikipedia.org/wiki/Biliary_tract "Biliary tract") (including the [gallbladder](https://en.wikipedia.org/wiki/Gallbladder "Gallbladder") and [bile ducts](https://en.wikipedia.org/wiki/Bile_duct "Bile duct")), and the [pancreas](https://en.wikipedia.org/wiki/Pancreas "Pancreas").[\[14\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Moore_2016-14) The midgut contains portions of the [duodenum](https://en.wikipedia.org/wiki/Duodenum "Duodenum") (distal), [cecum](https://en.wikipedia.org/wiki/Cecum "Cecum"), [appendix](https://en.wikipedia.org/wiki/Appendix_\(anatomy\) "Appendix (anatomy)"), [ascending colon](https://en.wikipedia.org/wiki/Ascending_colon "Ascending colon"), and first half of the [transverse colon](https://en.wikipedia.org/wiki/Transverse_colon "Transverse colon").[\[14\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Moore_2016-14) The hindgut contains the distal half of the transverse colon, [descending colon](https://en.wikipedia.org/wiki/Descending_colon "Descending colon"), [sigmoid colon](https://en.wikipedia.org/wiki/Sigmoid_colon "Sigmoid colon"), [rectum](https://en.wikipedia.org/wiki/Rectum "Rectum"), and superior [anal canal](https://en.wikipedia.org/wiki/Anal_canal "Anal canal").[\[14\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Moore_2016-14) Each subsection of the gut has an associated visceral afferent nerve that transmits sensory information from the viscera to the spinal cord.[\[16\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-16) The visceral sensory information from the gut traveling to the spinal cord, termed the visceral afferent, is non-specific and overlaps with the somatic afferent nerves, which are very specific.[\[17\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Neumayer_2013-17) Therefore, visceral afferent information traveling to the spinal cord can present in the distribution of the somatic afferent nerve; this is why [appendicitis](https://en.wikipedia.org/wiki/Appendicitis "Appendicitis") initially presents with T10 periumbilical pain when it first begins and becomes T12 pain as the abdominal wall peritoneum (which is rich with somatic afferent nerves) is involved.[\[17\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Neumayer_2013-17) A thorough patient history and physical examination is used to better understand the underlying cause of abdominal pain. The process of gathering a history may include:[\[18\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Bickley_2016-18) - Identifying more information about the [chief complaint](https://en.wikipedia.org/wiki/Presenting_problem "Presenting problem") by eliciting a [history of present illness](https://en.wikipedia.org/wiki/History_of_the_present_illness "History of the present illness"); i.e. a narrative of the current symptoms such as the onset, location, duration, character, aggravating or relieving factors, and temporal nature of the pain. Identifying other possible factors may aid in the diagnosis of the underlying cause of abdominal pain, such as recent travel, recent contact with other ill individuals, and for females, a thorough [gynecologic](https://en.wikipedia.org/wiki/Gynaecology "Gynaecology") history. - Learning about the patient's past medical history, focusing on any prior issues or surgical procedures. - Clarifying the patient's current medication regimen, including prescriptions, over-the-counter medications, and supplements. - Confirming the patient's drug and food allergies. - Discussing with the patient any family history of disease processes, focusing on conditions that might resemble the patient's current presentation. - Discussing with the patient any health-related behaviors (e.g. tobacco use, alcohol consumption, drug use, and sexual activity) that might make certain diagnoses more likely. - Reviewing the presence of non-abdominal symptoms (e.g., [fever](https://en.wikipedia.org/wiki/Fever "Fever"), chills, [chest pain](https://en.wikipedia.org/wiki/Chest_pain "Chest pain"), [shortness of breath](https://en.wikipedia.org/wiki/Shortness_of_breath "Shortness of breath"), [vaginal bleeding](https://en.wikipedia.org/wiki/Vaginal_bleeding "Vaginal bleeding")) that can further clarify the diagnostic picture. - Using [Carnett's sign](https://en.wikipedia.org/wiki/Carnett%27s_sign "Carnett's sign") to differentiate between [visceral pain](https://en.wikipedia.org/wiki/Visceral_pain "Visceral pain") and pain originating in the muscles of the abdominal wall.[\[19\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-19) After gathering a thorough history, one should perform a [physical exam](https://en.wikipedia.org/wiki/Physical_examination "Physical examination") in order to identify important physical signs that might clarify the diagnosis, including a [cardiovascular exam](https://en.wikipedia.org/wiki/Cardiovascular_examination "Cardiovascular examination"), lung exam, thorough abdominal exam, and for females, a [genitourinary](https://en.wikipedia.org/wiki/Genitourinary_system "Genitourinary system") exam.[\[18\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Bickley_2016-18) Additional investigations that can aid diagnosis include:[\[20\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Cartwright_2008-20) - Blood tests including [complete blood count](https://en.wikipedia.org/wiki/Complete_blood_count "Complete blood count"), [basic metabolic panel](https://en.wikipedia.org/wiki/Basic_metabolic_panel "Basic metabolic panel"), [electrolytes](https://en.wikipedia.org/wiki/Electrolyte "Electrolyte"), [liver function tests](https://en.wikipedia.org/wiki/Liver_function_tests "Liver function tests"), [amylase](https://en.wikipedia.org/wiki/Amylase "Amylase"), [lipase](https://en.wikipedia.org/wiki/Lipase "Lipase"), [troponin I](https://en.wikipedia.org/wiki/Troponin_I "Troponin I"), and for females, a serum [pregnancy test](https://en.wikipedia.org/wiki/Pregnancy_test "Pregnancy test"). - [Urinalysis](https://en.wikipedia.org/wiki/Urinalysis "Urinalysis") - Imaging including chest and abdominal [X-rays](https://en.wikipedia.org/wiki/X-ray "X-ray") - [Electrocardiogram](https://en.wikipedia.org/wiki/Electrocardiograph "Electrocardiograph") If diagnosis remains unclear after history, examination, and basic investigations as above, then more advanced investigations may reveal a diagnosis. Such tests include:[\[20\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Cartwright_2008-20) - [Computed tomography](https://en.wikipedia.org/wiki/Computed_tomography "Computed tomography") of the abdomen/pelvis - Abdominal or pelvic [ultrasound](https://en.wikipedia.org/wiki/Ultrasound "Ultrasound") - [Endoscopy](https://en.wikipedia.org/wiki/Endoscopy "Endoscopy") or [colonoscopy](https://en.wikipedia.org/wiki/Colonoscopy "Colonoscopy") The management of abdominal pain depends on many factors, including the etiology of the pain. Some behavioural changes implemented to prevent pain include: resting after a meal, chewing food completely and slowly, and avoiding stressful and high excitement situations after a meal. Such at home strategies may reduce the need to seek professional assistance via prevention of future abdominal pain.[\[21\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-21) In the emergency department, a person presenting with abdominal pain may initially require IV fluids due to decreased intake secondary to abdominal pain and possible emesis or vomiting.[\[22\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Mahadevan-22) Treatment for abdominal pain includes analgesia, such as non-opioid (ketorolac) and opioid medications ([morphine](https://en.wikipedia.org/wiki/Morphine "Morphine"), [fentanyl](https://en.wikipedia.org/wiki/Fentanyl "Fentanyl")).[\[22\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Mahadevan-22) Choice of [analgesia](https://en.wikipedia.org/wiki/Analgesia "Analgesia") is dependent on the cause of the pain, as [ketorolac](https://en.wikipedia.org/wiki/Ketorolac "Ketorolac") can worsen some intra-abdominal processes.[\[22\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Mahadevan-22) Patients presenting to the emergency department with abdominal pain may receive a "GI cocktail" that includes an [antacid](https://en.wikipedia.org/wiki/Antacid "Antacid") (examples include [omeprazole](https://en.wikipedia.org/wiki/Omeprazole "Omeprazole"), [famotidine](https://en.wikipedia.org/wiki/Famotidine "Famotidine"), [magnesium hydroxide](https://en.wikipedia.org/wiki/Magnesium_hydroxide "Magnesium hydroxide"), and [calcium carbonate](https://en.wikipedia.org/wiki/Calcium_carbonate "Calcium carbonate")) and [lidocaine](https://en.wikipedia.org/wiki/Lidocaine "Lidocaine").[\[22\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Mahadevan-22) After addressing pain, there may be a role for [antimicrobial](https://en.wikipedia.org/wiki/Antimicrobial "Antimicrobial") treatment in some cases of abdominal pain.[\[22\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Mahadevan-22) [Butylscopolamine](https://en.wikipedia.org/wiki/Butylscopolamine "Butylscopolamine") (Buscopan) is used to treat cramping abdominal pain with some success.[\[23\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-23) Surgical management for causes of abdominal pain includes but is not limited to [cholecystectomy](https://en.wikipedia.org/wiki/Cholecystectomy "Cholecystectomy"), [appendectomy](https://en.wikipedia.org/wiki/Appendectomy "Appendectomy"), and exploratory [laparotomy](https://en.wikipedia.org/wiki/Laparotomy "Laparotomy").\[[citation needed](https://en.wikipedia.org/wiki/Wikipedia:Citation_needed "Wikipedia:Citation needed")\] Below is a brief overview of abdominal pain emergencies. \| Condition \| Presentation \| Diagnosis \| Management \| \|---\|---\|---\|---\| \| [Appendicitis](https://en.wikipedia.org/wiki/Appendicitis "Appendicitis")[\[24\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Sherman_2016-24) \| Abdominal pain, nausea, vomiting, fever Periumbilical pain, migrates to RLQ \| Clinical (history and physical exam) Abdominal CT \| Patient made NPO (nothing by mouth) IV fluids as neededGeneral surgery consultation, possible [appendectomy](https://en.wikipedia.org/wiki/Appendectomy "Appendectomy")AntibioticsPain control \| \| [Cholecystitis](https://en.wikipedia.org/wiki/Cholecystitis "Cholecystitis")[\[24\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Sherman_2016-24) \| Abdominal pain (RUQ, radiates epigastric), nausea, vomiting, fever, [Murphy's sign](https://en.wikipedia.org/wiki/Murphy%27s_sign "Murphy's sign") \| Clinical (history and physical exam) Imaging (RUQ ultrasound)Labs ([leukocytosis](https://en.wikipedia.org/wiki/Leukocytosis "Leukocytosis"), [transamintis](https://en.wikipedia.org/wiki/Elevated_transaminases "Elevated transaminases"), [hyperbilirubinemia](https://en.wikipedia.org/wiki/Hyperbilirubinemia "Hyperbilirubinemia")) \| Patient made NPO (nothing by mouth) IV fluids as neededGeneral surgery consultation, possible [cholecystectomy](https://en.wikipedia.org/wiki/Cholecystectomy "Cholecystectomy")AntibioticsPain, nausea control \| \| [Acute pancreatitis](https://en.wikipedia.org/wiki/Acute_pancreatitis "Acute pancreatitis")[\[24\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Sherman_2016-24) \| Abdominal pain (sharp epigastric, shooting to back), nausea, vomiting \| Clinical (history and physical exam) Labs (elevated [lipase](https://en.wikipedia.org/wiki/Lipase "Lipase"))Imaging (abdominal CT, ultrasound) \| Patient made NPO (nothing by mouth) IV fluids as neededPain, nausea controlPossibly consultation of [general surgery](https://en.wikipedia.org/wiki/Surgery "Surgery") or [interventional radiology](https://en.wikipedia.org/wiki/Interventional_radiology "Interventional radiology") \| \| [Bowel obstruction](https://en.wikipedia.org/wiki/Bowel_obstruction "Bowel obstruction")[\[24\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Sherman_2016-24) \| Abdominal pain (diffuse, crampy), [bilious](https://en.wikipedia.org/wiki/Bile "Bile") [emesis](https://en.wikipedia.org/wiki/Vomiting "Vomiting"), [constipation](https://en.wikipedia.org/wiki/Constipation "Constipation") \| Clinical (history and physical exam) Imaging (abdominal X-ray, abdominal CT) \| Patient made NPO (nothing by mouth) IV fluids as needed[Nasogastric tube](https://en.wikipedia.org/wiki/Nasogastric_intubation "Nasogastric intubation") placement[General surgery](https://en.wikipedia.org/wiki/General_surgery "General surgery") consultationPain control \| \| [Upper GI bleed](https://en.wikipedia.org/wiki/Upper_gastrointestinal_bleeding "Upper gastrointestinal bleeding")[\[24\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Sherman_2016-24) \| Abdominal pain (epigastric), [hematochezia](https://en.wikipedia.org/wiki/Hematochezia "Hematochezia"), [melena](https://en.wikipedia.org/wiki/Melena "Melena"), [hematemesis](https://en.wikipedia.org/wiki/Hematemesis "Hematemesis"), [hypovolemia](https://en.wikipedia.org/wiki/Hypovolemia "Hypovolemia") \| Clinical (history & physical exam, including [digital rectal exam](https://en.wikipedia.org/wiki/Rectal_examination "Rectal examination")) Labs ([complete blood count](https://en.wikipedia.org/wiki/Complete_blood_count "Complete blood count"), coagulation profile, [transaminases](https://en.wikipedia.org/wiki/Transaminase "Transaminase"), [stool guaiac](https://en.wikipedia.org/wiki/Stool_guaiac_test "Stool guaiac test")) \| Aggressive IV fluid resuscitation [Blood transfusion](https://en.wikipedia.org/wiki/Blood_transfusion "Blood transfusion") as neededMedications: [proton pump inhibitor](https://en.wikipedia.org/wiki/Proton-pump_inhibitor "Proton-pump inhibitor"), [octreotide](https://en.wikipedia.org/wiki/Octreotide "Octreotide")Stable patient: observationUnstable patient: consultation ([general surgery](https://en.wikipedia.org/wiki/General_surgery "General surgery"), [gastroenterology](https://en.wikipedia.org/wiki/Gastroenterology "Gastroenterology"), [interventional radiology](https://en.wikipedia.org/wiki/Interventional_radiology "Interventional radiology")) \| \| Lower [GI bleed](https://en.wikipedia.org/wiki/Gastrointestinal_bleeding "Gastrointestinal bleeding")[\[24\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Sherman_2016-24) \| Abdominal pain, [hematochezia](https://en.wikipedia.org/wiki/Hematochezia "Hematochezia"), [melena](https://en.wikipedia.org/wiki/Melena "Melena"), [hypovolemia](https://en.wikipedia.org/wiki/Hypovolemia "Hypovolemia") \| Clinical (history and physical exam, including [digital rectal exam](https://en.wikipedia.org/wiki/Rectal_examination "Rectal examination")) Labs ([complete blood count](https://en.wikipedia.org/wiki/Complete_blood_count "Complete blood count"), coagulation profile, [transaminases](https://en.wikipedia.org/wiki/Transaminase "Transaminase"), [stool guaiac](https://en.wikipedia.org/wiki/Stool_guaiac_test "Stool guaiac test")) \| Aggressive IV fluid resuscitation [Blood transfusion](https://en.wikipedia.org/wiki/Blood_transfusion "Blood transfusion") as neededMedications: [proton pump inhibitor](https://en.wikipedia.org/wiki/Proton-pump_inhibitor "Proton-pump inhibitor")Stable patient: observationUnstable patient: consultation ([general surgery](https://en.wikipedia.org/wiki/General_surgery "General surgery"), [gastroenterology](https://en.wikipedia.org/wiki/Gastroenterology "Gastroenterology"), [interventional radiology](https://en.wikipedia.org/wiki/Interventional_radiology "Interventional radiology")) \| \| Perforated Viscous[\[24\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Sherman_2016-24) \| Abdominal pain (sudden onset of localized pain), [abdominal distension](https://en.wikipedia.org/wiki/Abdominal_distension "Abdominal distension"), rigid abdomen \| Clinical (history and physical exam) Imaging (abdominal X-ray or CT showing free air)Labs ([complete blood count](https://en.wikipedia.org/wiki/Complete_blood_count "Complete blood count")) \| Aggressive IV fluid resuscitation [General surgery](https://en.wikipedia.org/wiki/General_surgery "General surgery") consultationAntibiotics \| \| [Volvulus](https://en.wikipedia.org/wiki/Volvulus "Volvulus")[\[24\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Sherman_2016-24) \| [Sigmoid colon volvulus](https://en.wikipedia.org/wiki/Sigmoid_colon_volvulus "Sigmoid colon volvulus"): Abdominal pain (\>2 days, distention, constipation) Cecal volvulus: Abdominal pain (acute onset), nausea, vomiting \| Clinical (history and physical exam) Imaging (abdominal X-ray or CT) \| Sigmoid: [Gastroenterology](https://en.wikipedia.org/wiki/Gastroenterology "Gastroenterology") consultation ([flexibile sigmoidoscopy](https://en.wikipedia.org/wiki/Sigmoidoscopy "Sigmoidoscopy")) Cecal: [General surgery](https://en.wikipedia.org/wiki/General_surgery "General surgery") consultation ([right hemicolectomy](https://en.wikipedia.org/wiki/Colectomy "Colectomy")) \| \| [Ectopic pregnancy](https://en.wikipedia.org/wiki/Ectopic_pregnancy "Ectopic pregnancy")[\[24\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Sherman_2016-24) \| Abdominal and pelvic pain, bleeding If ruptured ectopic pregnancy, the patient may present with peritoneal irritation and [hypovolemic shock](https://en.wikipedia.org/wiki/Hypovolemic_shock "Hypovolemic shock") \| Clinical (history and physical exam) Labs: [complete blood count](https://en.wikipedia.org/wiki/Complete_blood_count "Complete blood count"), urine pregnancy test followed with quantitative blood [beta-hCG](https://en.wikipedia.org/wiki/Human_chorionic_gonadotropin "Human chorionic gonadotropin")Imaging: [transvaginal ultrasound](https://en.wikipedia.org/wiki/Vaginal_ultrasonography "Vaginal ultrasonography") \| If patient is unstable: IV fluid resuscitation, urgent [obstetrics and gynecology](https://en.wikipedia.org/wiki/Obstetrics_and_gynaecology "Obstetrics and gynaecology") consultation If patient is stable: continue diagnostic workup, establish [OBGYN](https://en.wikipedia.org/wiki/Obstetrics_and_gynaecology "Obstetrics and gynaecology") follow-up \| \| [Abdominal aortic aneurysm](https://en.wikipedia.org/wiki/Abdominal_aortic_aneurysm "Abdominal aortic aneurysm")[\[24\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Sherman_2016-24) \| Abdominal pain, flank pain, back pain, hypotension, pulsatile abdominal mass \| Clinical (history and physical exam) Imaging: Ultrasound, [CT angiography](https://en.wikipedia.org/wiki/Computed_tomography_angiography "Computed tomography angiography"), MRA/[magnetic resonance angiography](https://en.wikipedia.org/wiki/Magnetic_resonance_angiography "Magnetic resonance angiography") \| If patient is unstable: IV fluid resuscitation, urgent surgical consultation If patient is stable: admit for observation \| \| [Aortic dissection](https://en.wikipedia.org/wiki/Aortic_dissection "Aortic dissection")[\[24\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Sherman_2016-24) \| Abdominal pain (sudden onset of epigastric or back pain), hypertension, new aortic [murmur](https://en.wikipedia.org/wiki/Heart_murmur "Heart murmur") \| Clinical (history and physical exam) Imaging: Chest X-ray (showing widened [mediastinum](https://en.wikipedia.org/wiki/Mediastinum "Mediastinum")), [CT angiography](https://en.wikipedia.org/wiki/Computed_tomography_angiography "Computed tomography angiography"), [MRA](https://en.wikipedia.org/wiki/Magnetic_resonance_angiography "Magnetic resonance angiography"), [transthoracic echocardiogram](https://en.wikipedia.org/wiki/Transthoracic_echocardiogram "Transthoracic echocardiogram")/TTE, [transesophageal echocardiogram](https://en.wikipedia.org/wiki/Transesophageal_echocardiogram "Transesophageal echocardiogram")/TEE \| IV fluid resuscitation [Blood transfusion](https://en.wikipedia.org/wiki/Blood_transfusion "Blood transfusion") as needed (obtain [type and cross](https://en.wikipedia.org/wiki/Blood_transfusion "Blood transfusion"))Medications: reduce blood pressure ([sodium nitroprusside](https://en.wikipedia.org/wiki/Sodium_nitroprusside "Sodium nitroprusside") plus [beta blocker](https://en.wikipedia.org/wiki/Beta_blocker "Beta blocker") or [calcium channel blocker](https://en.wikipedia.org/wiki/Calcium_channel_blocker "Calcium channel blocker"))Surgery consultation \| \| [Liver injury](https://en.wikipedia.org/wiki/Liver_injury "Liver injury")[\[24\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Sherman_2016-24) \| After trauma ([blunt](https://en.wikipedia.org/wiki/Blunt_trauma "Blunt trauma") or [penetrating](https://en.wikipedia.org/wiki/Penetrating_trauma "Penetrating trauma")), abdominal pain (RUQ), right rib pain, right flank pain, right shoulder pain \| Clinical (history and physical exam) Imaging: [FAST](https://en.wikipedia.org/wiki/Focused_assessment_with_sonography_for_trauma "Focused assessment with sonography for trauma") examination, CT of abdomen and pelvis[Diagnostic peritoneal aspiration and lavage](https://en.wikipedia.org/wiki/Diagnostic_peritoneal_lavage "Diagnostic peritoneal lavage") \| Resuscitation ([advanced trauma life support](https://en.wikipedia.org/wiki/Advanced_trauma_life_support "Advanced trauma life support")) with IV fluids ([crystalloid](https://en.wikipedia.org/wiki/Fluid_replacement "Fluid replacement")) and [blood transfusion](https://en.wikipedia.org/wiki/Blood_transfusion "Blood transfusion") If patient is unstable: [general](https://en.wikipedia.org/wiki/General_surgery "General surgery") or [trauma surgery](https://en.wikipedia.org/wiki/Trauma_surgery "Trauma surgery") consultation with subsequent [exploratory laparotomy](https://en.wikipedia.org/wiki/Exploratory_laparotomy "Exploratory laparotomy") \| \| [Splenic injury](https://en.wikipedia.org/wiki/Splenic_injury "Splenic injury")[\[24\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Sherman_2016-24) \| After trauma ([blunt](https://en.wikipedia.org/wiki/Blunt_trauma "Blunt trauma") or [penetrating](https://en.wikipedia.org/wiki/Penetrating_trauma "Penetrating trauma")), abdominal pain (LUQ), left rib pain, left flank pain \| Clinical (history and physical exam) Imaging: [FAST](https://en.wikipedia.org/wiki/Focused_assessment_with_sonography_for_trauma "Focused assessment with sonography for trauma") examination, CT of abdomen and pelvis[Diagnostic peritoneal aspiration and lavage](https://en.wikipedia.org/wiki/Diagnostic_peritoneal_lavage "Diagnostic peritoneal lavage") \| Resuscitation ([advanced trauma life support](https://en.wikipedia.org/wiki/Advanced_trauma_life_support "Advanced trauma life support")) with IV fluids ([crystalloid](https://en.wikipedia.org/wiki/Fluid_replacement "Fluid replacement")) and [blood transfusion](https://en.wikipedia.org/wiki/Blood_transfusion "Blood transfusion") If patient is unstable: [general](https://en.wikipedia.org/wiki/General_surgery "General surgery") or [trauma surgery](https://en.wikipedia.org/wiki/Trauma_surgery "Trauma surgery") consultation with subsequent [exploratory laparotomy](https://en.wikipedia.org/wiki/Exploratory_laparotomy "Exploratory laparotomy") and possible [splenectomy](https://en.wikipedia.org/wiki/Splenectomy "Splenectomy")If patient is stable: medical management, consultation of [interventional radiology](https://en.wikipedia.org/wiki/Interventional_radiology "Interventional radiology") for possible [arterial embolization](https://en.wikipedia.org/wiki/Embolization "Embolization") \| One well-known aspect of primary health care is its low prevalence of potentially dangerous abdominal pain causes. Patients with abdominal pain have a higher percentage of unexplained complaints (category "no diagnosis") than patients with other symptoms (such as [dyspnea](https://en.wikipedia.org/wiki/Dyspnea "Dyspnea") or [chest pain](https://en.wikipedia.org/wiki/Chest_pain "Chest pain")).[\[25\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-A_C_T_R_p.-25) Most people who suffer from stomach pain have a benign issue, like [dyspepsia](https://en.wikipedia.org/wiki/Indigestion "Indigestion").[\[26\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Gulacti_Arslan_Ooi_Tuck_2001_pp._123%E2%80%93136-26) In general, it is discovered that 20% to 25% of patients with abdominal pain have a serious condition that necessitates admission to an acute care hospital.[\[27\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Chandramohan_Pari_Schrock_Lum_1991_pp._503%E2%80%93507-27) Abdominal pain is the reason about 3% of adults see their family physician.[\[2\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Vin2014-2) Rates of [emergency department](https://en.wikipedia.org/wiki/Emergency_department "Emergency department") (ED) visits in the United States for abdominal pain increased 18% from 2006 through to 2011. This was the largest increase out of 20 common conditions seen in the ED. The rate of ED use for nausea and vomiting also increased 18%.[\[28\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-28) ## Special populations \[[edit](https://en.wikipedia.org/w/index.php?title=Abdominal_pain&action=edit&section=19 "Edit section: Special populations")\] More time and resources are used on older patients with abdominal pain than on any other patient presentation in the emergency department (ED).[\[29\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-SA_LZ_p.-29) Compared to younger patients with the same complaint, their length of stay is 20% longer, they need to be admitted almost half the time, and they need surgery 1/3 of the time.[\[30\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Rodr%C3%ADguez-Lomba_Pulido-P%C3%A9rez_Ricciardi_Marcello_1976_pp._219%E2%80%93223-30) Age does not reduce the total number of [T cells](https://en.wikipedia.org/wiki/T_cell "T cell"), but it does reduce their functionality. The elderly person's ability to fight infection is weakened as a result.[\[31\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Weyand_Goronzy_p.-31) Additionally, they have changed the strength and integrity of their skin and [mucous membranes](https://en.wikipedia.org/wiki/Mucous_membrane "Mucous membrane"), which are physical barriers to infection. It is well known that older patients experience altered pain perception.[\[32\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Sherman_p.-32) The challenge of obtaining a sufficient history from an elderly patient can be attributed to multiple factors. Reduced memory or hearing could make the issue worse. It is common to encounter stoicism combined with a fear of losing one's independence if a serious condition is discovered. Changes in mental status, whether acute or chronic, are common.[\[33\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Isani_Kim_Mateu_Tormo_2006_pp._371%E2%80%93388-33) Unique clinical challenges arise when pregnant women experience abdominal pain. First off, there are many possible causes of abdominal pain during pregnancy. These include intraabdominal diseases that arise incidentally during pregnancy as well as obstetric or gynecologic disorders associated with pregnancy. Secondly, pregnancy modifies the natural history and clinical manifestation of numerous abdominal disorders.[\[34\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-34) Third, pregnancy modifies and limits the diagnostic assessment. For instance, concerns about fetal safety during pregnancy are raised by invasive exams and radiologic testing. Fourth, while receiving therapy during pregnancy, the mother's and the fetus' interests need to be taken into account.[\[35\]](https://en.wikipedia.org/wiki/Abdominal_pain#cite_note-Souza_Ferreira_Young_Cerit_2003_pp._1%E2%80%9358-35) - [Abdominal distension](https://en.wikipedia.org/wiki/Abdominal_distension "Abdominal distension") - [Abdominal mass](https://en.wikipedia.org/wiki/Abdominal_mass "Abdominal mass") 1. [^](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Stat2018_1-0) Patterson JW, Dominique E (14 November 2018). "Acute Abdomenal". StatPearls. [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [29083722](https://pubmed.ncbi.nlm.nih.gov/29083722). 2. ^ [*a](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Vin2014_2-0) [b](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Vin2014_2-1) [c](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Vin2014_2-2) [d](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Vin2014_2-3) [e](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Vin2014_2-4) Viniol A, Keunecke C, Biroga T, Stadje R, Dornieden K, Bösner S, et al. (October 2014). ["Studies of the symptom abdominal pain—a systematic review and meta-analysis"](https://doi.org/10.1093%2Ffampra%2Fcmu036). Family Practice. 31* (5): 517–29\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1093/fampra/cmu036](https://doi.org/10.1093%2Ffampra%2Fcmu036). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [24987023](https://pubmed.ncbi.nlm.nih.gov/24987023). 3. ^ [*a](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Hopcroft2020_3-0) [b](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Hopcroft2020_3-1) Hopcroft K, Forte V (2020). ["Abdomen"](https://books.google.com/books?id=pr_gDwAAQBAJ&pg=PA9). Symptom Sorter* (6th ed.). Boca Raton: CRC Press. pp. 9–17\. [ISBN](https://en.wikipedia.org/wiki/ISBN_\(identifier\) "ISBN (identifier)") [9780367468101](https://en.wikipedia.org/wiki/Special:BookSources/9780367468101 "Special:BookSources/9780367468101") . 4. ^ [*a](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Sherman_1990_r770_4-0) [b](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Sherman_1990_r770_4-1) Sherman R (1990). [Abdominal Pain](https://www.ncbi.nlm.nih.gov/books/NBK412/). Butterworths. [ISBN](https://en.wikipedia.org/wiki/ISBN_\(identifier\) "ISBN (identifier)") [978-0-409-90077-4](https://en.wikipedia.org/wiki/Special:BookSources/978-0-409-90077-4 "Special:BookSources/978-0-409-90077-4") . [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [21250252](https://pubmed.ncbi.nlm.nih.gov/21250252). Retrieved 28 December 2023. 5. [^](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-5)* Hung A, Calderbank T, Samaan MA, Plumb AA, Webster G (1 January 2021). ["Ischaemic colitis: practical challenges and evidence-based recommendations for management"](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7802492). Frontline Gastroenterology. 12 (1): 44–52\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1136/flgastro-2019-101204](https://doi.org/10.1136%2Fflgastro-2019-101204). [ISSN](https://en.wikipedia.org/wiki/ISSN_\(identifier\) "ISSN (identifier)") [2041-4137](https://search.worldcat.org/issn/2041-4137). [PMC](https://en.wikipedia.org/wiki/PMC_\(identifier\) "PMC (identifier)") [7802492](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7802492). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [33489068](https://pubmed.ncbi.nlm.nih.gov/33489068). 6. [^](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Spangler_2014_6-0) Spangler R, Van Pham T, Khoujah D, Martinez JP (2014). ["Abdominal emergencies in the geriatric patient"](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4306086). International Journal of Emergency Medicine. 7 43. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1186/s12245-014-0043-2](https://doi.org/10.1186%2Fs12245-014-0043-2). [PMC](https://en.wikipedia.org/wiki/PMC_\(identifier\) "PMC (identifier)") [4306086](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4306086). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [25635203](https://pubmed.ncbi.nlm.nih.gov/25635203). 7. ^ [*a](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-aa_7-0) [b](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-aa_7-1) [c](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-aa_7-2) [d](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-aa_7-3) [e](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-aa_7-4) Patterson JW, Kashyap S, Dominique E (2023), ["Acute Abdomen"](https://www.ncbi.nlm.nih.gov/books/NBK459328/), StatPearls, Treasure Island (FL): StatPearls Publishing, [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [29083722](https://pubmed.ncbi.nlm.nih.gov/29083722), retrieved 23 September 2023 8. [^](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-8)* ["Appendicitis"](https://www.lecturio.com/concepts/appendicitis/). The Lecturio Medical Concept Library. Retrieved 1 July 2021. 9. [^](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-9) Arendt-Nielsen L, Svensson P (March 2001). ["Referred Muscle Pain: Basic and Clinical Findings"](https://doi.org/10.1097%2F00002508-200103000-00003). The Clinical Journal of Pain. 17 (1): 11–19\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1097/00002508-200103000-00003](https://doi.org/10.1097%2F00002508-200103000-00003). [ISSN](https://en.wikipedia.org/wiki/ISSN_\(identifier\) "ISSN (identifier)") [0749-8047](https://search.worldcat.org/issn/0749-8047). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [11289083](https://pubmed.ncbi.nlm.nih.gov/11289083). 10. [^](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-10) Collantes Celador E, Rudiger J, Tameem A, eds. (2022). Essential Notes in Pain Medicine (1st ed.). United Kingdom: Oxford University Press. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1093/med/9780198799443.001.0001](https://doi.org/10.1093%2Fmed%2F9780198799443.001.0001). [ISBN](https://en.wikipedia.org/wiki/ISBN_\(identifier\) "ISBN (identifier)") [978-0-19-879944-3](https://en.wikipedia.org/wiki/Special:BookSources/978-0-19-879944-3 "Special:BookSources/978-0-19-879944-3") . 11. [^](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-11) Burnett LS (April 1988). "Gynecologic causes of the acute abdomen". The Surgical Clinics of North America. 68 (2): 385–398\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1016/s0039-6109(16)44484-1](https://doi.org/10.1016%2Fs0039-6109%2816%2944484-1). [ISSN](https://en.wikipedia.org/wiki/ISSN_\(identifier\) "ISSN (identifier)") [0039-6109](https://search.worldcat.org/issn/0039-6109). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [3279553](https://pubmed.ncbi.nlm.nih.gov/3279553). 12. [^](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-12) Masters P (2015). IM Essentials. American College of Physicians. [ISBN](https://en.wikipedia.org/wiki/ISBN_\(identifier\) "ISBN (identifier)") [978-1-938921-09-4](https://en.wikipedia.org/wiki/Special:BookSources/978-1-938921-09-4 "Special:BookSources/978-1-938921-09-4") . 13. [^](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-13) LeBlond RF (2004). Diagnostics. US: McGraw-Hill Companies, Inc. [ISBN](https://en.wikipedia.org/wiki/ISBN_\(identifier\) "ISBN (identifier)") [978-0-07-140923-0](https://en.wikipedia.org/wiki/Special:BookSources/978-0-07-140923-0 "Special:BookSources/978-0-07-140923-0") . 14. ^ [*a](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Moore_2016_14-0) [b](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Moore_2016_14-1) [c](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Moore_2016_14-2) [d](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Moore_2016_14-3) [e](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Moore_2016_14-4) [f](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Moore_2016_14-5) Moore KL (2016). "11". The Developing Human Tenth Edition. Philadelphia, PA: Elsevier, Inc. pp. 209–240\. [ISBN](https://en.wikipedia.org/wiki/ISBN_\(identifier\) "ISBN (identifier)") [978-0-323-31338-4](https://en.wikipedia.org/wiki/Special:BookSources/978-0-323-31338-4 "Special:BookSources/978-0-323-31338-4") . 15. [^](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-15)* Hansen JT (2019). "4: Abdomen". Netter's Clinical Anatomy, 4e. Philadelphia, PA: Elsevier. pp. 157–231\. [ISBN](https://en.wikipedia.org/wiki/ISBN_\(identifier\) "ISBN (identifier)") [978-0-323-53188-7](https://en.wikipedia.org/wiki/Special:BookSources/978-0-323-53188-7 "Special:BookSources/978-0-323-53188-7") . 16. [^](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-16) Drake RL, Vogl AW, Mitchell AW (2015). "4: Abdomen". Gray's Anatomy For Students (Third ed.). Churchill Livingstone Elsevier. pp. 253–420\. [ISBN](https://en.wikipedia.org/wiki/ISBN_\(identifier\) "ISBN (identifier)") [978-0-7020-5131-9](https://en.wikipedia.org/wiki/Special:BookSources/978-0-7020-5131-9 "Special:BookSources/978-0-7020-5131-9") . 17. ^ [*a](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Neumayer_2013_17-0) [b](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Neumayer_2013_17-1) Neumayer L, Dangleben DA, Fraser S, Gefen J, Maa J, Mann BD (2013). "11: Abdominal Wall, Including Hernia". Essentials of General Surgery, 5e. Baltimore, MD: Wolters Kluwer Health. 18. ^ [a](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Bickley_2016_18-0) [b](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Bickley_2016_18-1) Bickley L (2016). Bates' Guide to Physical Examination & History Taking. Philadelphia, Pennsylvania: Lippincott Williams & Wilkins. [ISBN](https://en.wikipedia.org/wiki/ISBN_\(identifier\) "ISBN (identifier)") [978-1-4698-9341-9](https://en.wikipedia.org/wiki/Special:BookSources/978-1-4698-9341-9 "Special:BookSources/978-1-4698-9341-9") . 19. [^](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-19)* Karen M. Myrick, Laima Karosas (6 December 2019). [Advanced Health Assessment and Differential Diagnosis: Essentials for Clinical Practice](https://books.google.com/books?id=QTCeDwAAQBAJ&q=%22Carnett's+sign%22+diagnosis). Springer Publishing Company. p. 250. [ISBN](https://en.wikipedia.org/wiki/ISBN_\(identifier\) "ISBN (identifier)") [978-0-8261-6255-7](https://en.wikipedia.org/wiki/Special:BookSources/978-0-8261-6255-7 "Special:BookSources/978-0-8261-6255-7") . 20. ^ [*a](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Cartwright_2008_20-0) [b](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Cartwright_2008_20-1) Cartwright SL, Knudson MP (April 2008). ["Evaluation of acute abdominal pain in adults"](http://www.aafp.org/afp/2008/0401/p971.html). American Family Physician. 77* (7): 971–8\. [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [18441863](https://pubmed.ncbi.nlm.nih.gov/18441863). 21. [^](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-21) ["Indigestion: MedlinePlus Medical Encyclopedia"](https://medlineplus.gov/ency/article/003260.htm). medlineplus.gov. Retrieved 2 May 2023. 22. ^ [*a](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Mahadevan_22-0) [b](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Mahadevan_22-1) [c](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Mahadevan_22-2) [d](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Mahadevan_22-3) [e](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Mahadevan_22-4) Mahadevan SV. Essentials of Family Medicine 6e. p. 149. 23. [^](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-23)* Tytgat GN (2007). "Hyoscine butylbromide: a review of its use in the treatment of abdominal cramping and pain". Drugs. 67 (9): 1343–57\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.2165/00003495-200767090-00007](https://doi.org/10.2165%2F00003495-200767090-00007). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [17547475](https://pubmed.ncbi.nlm.nih.gov/17547475). [S2CID](https://en.wikipedia.org/wiki/S2CID_\(identifier\) "S2CID (identifier)") [46971321](https://api.semanticscholar.org/CorpusID:46971321). 24. ^ [*a](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Sherman_2016_24-0) [b](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Sherman_2016_24-1) [c](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Sherman_2016_24-2) [d](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Sherman_2016_24-3) [e](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Sherman_2016_24-4) [f](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Sherman_2016_24-5) [g](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Sherman_2016_24-6) [h](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Sherman_2016_24-7) [i](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Sherman_2016_24-8) [j](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Sherman_2016_24-9) [k](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Sherman_2016_24-10) [l](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Sherman_2016_24-11) [m](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-Sherman_2016_24-12) Sherman SC, Cico SJ, Nordquist E, Ross C, Wang E (2016). Atlas of Clinical Emergency Medicine. Wolters Kluwer. [ISBN](https://en.wikipedia.org/wiki/ISBN_\(identifier\) "ISBN (identifier)") [978-1-4511-8882-0](https://en.wikipedia.org/wiki/Special:BookSources/978-1-4511-8882-0 "Special:BookSources/978-1-4511-8882-0") . 25. [^](https://en.wikipedia.org/wiki/Abdominal_pain#cite_ref-A_C_T_R_p._25-0)* Viniol A, Keunecke C, Biroga T, Stadje R, Dornieden K, Bösner S, et al. (2014). "Studies of the symptom abdominal pain—a systematic review and meta-analysis". Family Practice. 31 (5): 517–529\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1093/fampra/cmu036](https://doi.org/10.1093%2Ffampra%2Fcmu036). [ISSN](https://en.wikipedia.org/wiki/ISSN_\(identifier\) "ISSN (identifier)") [1460-2229](https://search.worldcat.org/issn/1460-2229). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [24987023](https://pubmed.ncbi.nlm.nih.gov/24987023). 26. 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[ISSN](https://en.wikipedia.org/wiki/ISSN_\(identifier\) "ISSN (identifier)") [0031-3955](https://search.worldcat.org/issn/0031-3955). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [16487787](https://pubmed.ncbi.nlm.nih.gov/16487787). [S2CID](https://en.wikipedia.org/wiki/S2CID_\(identifier\) "S2CID (identifier)") [17103933](https://api.semanticscholar.org/CorpusID:17103933). - [![](https://upload.wikimedia.org/wikipedia/commons/thumb/d/df/Wikibooks-logo-en-noslogan.svg/20px-Wikibooks-logo-en-noslogan.svg.png)](https://en.wikipedia.org/wiki/File:Wikibooks-logo-en-noslogan.svg) [Abdominal Pain](https://en.wikibooks.org/wiki/Internal_Medicine/Abdominal_Pain "wikibooks:Internal Medicine/Abdominal Pain") at Wikibooks - [Cleveland Clinic](https://my.clevelandclinic.org/health/symptoms/4167-abdominal-pain) - [Mayo Clinic](https://www.mayoclinic.org/symptoms/abdominal-pain/basics/definition/sym-20050728)
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