The Acute and Painful Abdomen

This is a two-part video series outlining a framework and approach to dealing with the acute and painful abdomen in an atraumatic context.

Part I covers some anatomy and physiology that explains why abdominal pain can be so hard to diagnose, and examination history pearls, and the ups and downs of investigations and why they often aren’t the silver bullet we hope for.

Part II explores some specific conditions across vascular, gastrointestinal, genitourinary and other aetiologies, as well as special considerations for elderly populations, and some thoughts on disposition and take-home pearls.

Part I

Part I of our approach to acute abdominal pain covers the context, anatomy and physiology of abdominal pain, how to approach assessing the patient with abdominal pain, and a discussion about investigations and how they often don’t give us all the answers.

00:52 Context of the acute abdomen
02:20 Anatomy and physiology of abdominal pain
10:58 The history
18:06 The examination
28:00 Investigations

Part II

Welcome to part 2 of this informal chat about approaching acute abdominal pain and the acute abdomen. Remember, this is by no means exhaustive, and does NOT cover all salient topics (which would take many hours), but I hope to give some useful info and thoughts that have been pulled from a number of different sources and areas.

00:00 Intro
00:50 ‘Worst first’ considerations
01:07 Vascular
11:27 Gastrointestinal
19:40 Genitourinary
24:00 Extra-abdominal
27:36 Special considerations for elderly patients
33:31 Considerations for disposition
36:02 Final take-home pearls

Further learning / references:

  1. RCEM Learning – Abdominal Pain without Shock
  2. Evaluation and management of acute abdominal pain in the emergency department
  3. Abdominal emergencies in the geriatric patient
  4. Points & Pearls: Assessing abdominal pain in adults: a rational, cost-effective, and evidence-based strategy
  5. 10 Tips for Approaching Abdominal Pain in the Elderly
  6. Visceral Pain – the Ins and Outs, the Ups and Downs
  7. Assessment of Older Adults with Abdominal Pain in the Emergency Department: 10 Key Points – #57
  8. Guideline for the Diagnostic Pathway in Patients with Acute Abdominal Pain
  9. Routine abdominal X-rays in the emergency department: A thing of the past?
  10. Medical Concepts: Abdominal Pain Labs

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