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Abdo Pain (objective)
#fm

Abdo

  • peritoneal signs

  • Carnett’s sign (high ppv for abdo wall pain)

    • ↑ pain when supine pt raises head & shoulder, tensing abdo wall

  • Murphy’s sign (high ppv for choleycystitis)

  • Psoas sign (high ppv for appendicitis)

  • Sever pain out of proportion (ischemic bowel, pancreatitis)

  • restless/writhing (biliary/renal colic, testicular torsion)

  • LLQ tenderness (diverticulitis)

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e pancreatitis, MI, sepsis) Vitals Upper abdo pain - pay attention to Cardiac (ischemia) & lung (pneumonia) exams Tachypneic (pneumonia) <span>Abdo peritoneal signs Carnett’s sign (high ppv for abdo wall pain) ↑ pain when supine pt raises head & shoulder, tensing abdo wall Murphy’s sign (high ppv for choleycystitis) Psoas sign (high ppv for appendicitis) Sever pain out of proportion (ischemic bowel, pancreatitis) restless/writhing (biliary/renal colic, testicular torsion) LLQ tenderness (diverticulitis) Rectal & pelvic exams if lower abdo & pelvic pain DRE - fecal impaction, palpable mass, occult blood in stool Tenderness & ful

Original toplevel document

Abdo Pain
Cholecystitis (highest to lowest PPV) RUQ pain, fever, jaundice IBS algorithm <span>Objective General inspection Change in mental status (infection - UTI) Shock (perforated viscera, GI hemorrhage, severe pancreatitis, MI, sepsis) Vitals Upper abdo pain - pay attention to Cardiac (ischemia) & lung (pneumonia) exams Tachypneic (pneumonia) Abdo peritoneal signs Carnett’s sign (high ppv for abdo wall pain) ↑ pain when supine pt raises head & shoulder, tensing abdo wall Murphy’s sign (high ppv for choleycystitis) Psoas sign (high ppv for appendicitis) Sever pain out of proportion (ischemic bowel, pancreatitis) restless/writhing (biliary/renal colic, testicular torsion) LLQ tenderness (diverticulitis) Rectal & pelvic exams if lower abdo & pelvic pain DRE - fecal impaction, palpable mass, occult blood in stool Tenderness & fullness on R of rectum suggests retrocecal appendix Pelvic - vaginal discharge (vaginitis), cervical motion tenderness & peritoneal signs (ectopic pregnancy or other gyne complications e.g. tubo-ovarian abscess) S&S of surgical abdo Fever Protracted (prolonged) vomiting syncope/pre-syncope Evidence of GI blood loss


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