Abdominal Pain - Differential Diagnosis According to Localization of Abdominal Pain
Abdominal pain can originate from intra-abdominal and extra-abdominal or non-GI conditions; hence, it’s advisable to be systematic in your approach to narrow down your differential diagnoses. (i.e., Cardiac, GI, infectious, hematologic, urologic, gynecologic, etc.) When diagnosing abdominal pain, the differential diagnoses can be based on anatomic localization of pain (Figure 3). This, in turn, helps direct your approach. An EP should prioritize possible life-threatening conditions in his differential diagnoses, and be mindful of other possible extra-abdominal causes attributable to abdominal pain (Table 2). Keep in mind that the following list of differentials is not exhaustive and should be correlated with the localization of abdominal pain (Figure 3).
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** GrepMed Recommended Text: Evidence-Based Physical Diagnosis - https://amzn.to/361gAqL
Complex Regional Pain Syndrome (CRPS)
Diagnostic Criteria (The "Budapest Criteria"):
• Persistent pain out of proportion to any inciting event
• Symptoms in at least 3, and physical signs in at least 2 of the following 4 categories:
- Sensory: Hyperesthesia and/or allodynia
- Vasomotor: Temperature and/or skin color changes
- Edema/sudomotor: Edema and/or sweating changes
- Motor/trophic: Motor dysfunction and/or changes to hair, nails or skin
• Findings are not explained better by an alternative diagnosis
Clinical Features:
• Pain: "Burning" or "Stinging", Deep > Superficial, Continuous > Paroxysmal, Hyperalgesia (↑ sensitivity to painful stimuli), Allodynia (feeling pain in respon to stimuli not usually painful)
• Other Symptoms: Weakness, Tremor and myoclonic jerking, Edema, Skin color changes (livedo, cyanosis or hyperemia), ↑/↓ Temperature & sweating, Skin atrophy, Contractures
- Dr. Eric Strong @DrEricStrong - Strong Medicine https://www.youtube.com/c/EricsMedicalLectures/
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