Abdominal pain

Key Information

Appropriate Tests

 

Diagnosis based on history and physical examination; diagnostic imaging and pathology tests as appropriate.

See specific clinical problems eg Peritonitis, Pancreatitis, Diarrhoea, Hepatitis, Peptic ulcer.

See also Fever and abdominal pain.

Common causes of abdominal pain, 

  • Indigestion
  • Constipation
  • Stomach virus
  • Menstrual cramps
  • Food poisoning
  • Food allergies
  • Gas
  • Lactose intolerance
  • Ulcers
  • Pelvic inflammatory disease
  • Hernia
  • Gallstones
  • Kidney stones
  • Endometriosis
  • Crohn's disease
  • Urinary tract infection
  • Gastroesophageal reflux disease (GERD)
  • Appendicitis
  • Colic

 

Abdominal pain severe upper epigas

Consider: Blood culture, Urea, Electrolytes, Creatinine, Glucose, Liver function tests, Lactate dehydrogenase, Calcium, Phosphate, Albumin, Troponin I, Troponin T, Lipase, Beta HCG quantitation (female), Full blood count, Blood gas arterial, L-Lactate, Ward test urine and MCS if abnormalities detected.

See Guideline on Pathology testing in the Emergency department: Appendix 2.

Abdominal pain severe (lower)

Consider: Blood culture, Urea, Electrolytes, Creatinine, Glucose, Calcium, Phosphate, Albumin, Beta HCG quantitation (female), Full blood count.  

Consider Blood group and antibody screen if female. 

Consider L-Lactate. Ward test urine and MCS if positive.

See Guideline on Pathology testing in the Emergency department: Appendix 2

If inflammation/infection suspected

Full blood count, Blood film, C-Reactive protein or Erythrocyte sedimentation rate only occasionally useful. Urea, Urea urine, Electrolytes and Liver function tests.

If ectopic pregnancy suspected

Beta HCG quantitation on blood (EDTA or Heparin) or urine.

If pancreatitis suspected

Lipase or, if unavailable, Amylase.

If dehydration or electrolyte imbalance suspected

Consider Blood culture, Urea, Electrolytes, Glucose, Creatinine, Liver function tests, plus Lactate dehydrogenase, consider Calcium, Phosphate, Albumin, consider, Troponin I, Troponin T, Lipase, consider Beta HCG quantitation if female, Full blood count, Blood gas arterial and consider L-Lactate, Ward test urine and MCS if abnormalities detected.

See Guideline on Pathology testing in the Emergency department: Appendix 2.