Surgical Issues

Abdominal Pain

Visceral Pain
Anatomic Division Viscera Area to Which Pain Referred
Foregut Esophagus & duodenum Epigastrium
Midgut Jejunum to mid-transverse colon Umbilicus
Hindgut Mid-transverse colon to rectum Hypogastrium

Pain due to pancreatitis and nephrolithiasis commonly radiates to the back

Figure 10-1 Etiologies of abdominal pain based on location

Initial evaluation

  • History: onset of pain, location, exacerbating/relieving factors
  • Assoc. sx: fevers/chills, N/V, Δ in bowel habits (diarrhea/constipation, stool diam. or color, hematochezia, melena), jaundice, Δ in urine color, Δ in wt, menstrual hx in women
  • PMHx: previous incisions or abdominal surgeries; b/Gyn hx