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Evaluation of the adult with abdominal pain

Robert M Penner, BSc, MD, FRCPC, MSc
Mary B Fishman, MD
Sumit R Majumdar, MD, MPH
Section Editors
Andrew D Auerbach, MD, MPH
Mark D Aronson, MD
Deputy Editor
Daniel J Sullivan, MD, MPH


Abdominal pain can be a challenging complaint for both primary care and specialist clinicians because it is frequently a benign complaint, but it can also herald serious acute pathology.

Clinicians are responsible for trying to determine which patients can be safely observed or treated symptomatically and which require further investigation or specialist referral. This task is complicated by the fact that abdominal pain is often a nonspecific complaint that presents with other symptoms [1].

This topic reviews a diagnostic approach to nontraumatic abdominal pain in adults. The causes of abdominal pain and its pathophysiology, the evaluation of the adult with abdominal pain in the emergency department, and the evaluation of abdominal pain related to trauma is discussed elsewhere. (See "Causes of abdominal pain in adults" and "Evaluation of the adult with abdominal pain in the emergency department" and "Traumatic gastrointestinal injury in the adult patient".)


Abdominal pain is a common problem. Most patients have a benign and/or self-limited etiology, and the initial goal of evaluation is to identify those patients with a serious etiology that may require urgent intervention. A history and focused physical examination will lead to a differential diagnosis of abdominal pain, which will then inform further evaluation with laboratory evaluation and/or imaging.

History — The history of a patient with abdominal pain includes determining whether the pain is acute or chronic and a detailed description of the pain and associated symptoms, which should be interpreted with other aspects of the medical history.

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Literature review current through: Nov 2017. | This topic last updated: Nov 02, 2017.
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