Abdominal Pain

The most common chief complaint in Emergency Medicine is abdominal pain. Most students already have an understanding of the basic approach to this problem. We know to ask about fevers, palpate the abdomen, and give something for nausea. In this episode we will be discussing an additional 5 steps that tend to be overlooked with this chief complaint as well as some can’t miss items on your differential diagnosis. 

2 Comments

  1. Hi Dr. Olson,

    I am looking for your reference on the comment that geriatric patients presenting to ED with abdominal pain have a higher mortality rate than patients presenting to cardiac centers with STEMI (or something to this nature was said). Mentioned to my attending, but can’t find reference!

    Thanks so much, love the podcast

    • Zack

      November 3, 2019 at 8:23 am

      No study compares head to head that I can find. Current in-hospital mortality for STEMI at PCI capable centers 5-7% (Claeys MJ, Sinnaeve PR, Convens C, et al. STEMI mortality in community hospitals versus PCI-capable hospitals: results from a nationwide STEMI network programme. Eur Heart J Acute Cardiovasc Care. 2012;1(1):40–47)

      If you look at abdominal pain mortality data it depends on the study. From what I can find, the mortality number most frequently cited (10%) is traced back to a study from 1982.

      There is a more recent study from Turkey with geriatric abdominal pain mortality around 12% (Pınar Henden Çam, Ahmet Baydin, Savaş Yürüker, Ali Kemal Erenler, and Erdinç Şengüldür, “Investigation of Geriatric Patients with Abdominal Pain Admitted to Emergency Department,” Current Gerontology and Geriatrics Research, vol. 2018, Article ID 9109326, 8 pages, 2018.)

      Geriatric abdominal pain is very bad. Admittedly, there are lots of confounding factors between studies that make comparison difficult.

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