Aetiology of Abdominal Pain

Acute abdominal pain is normally thought of as pain of less than one week’s duration.

To aid initial diagnosis, investigation and management, abdominal pain can be categorised into one of five areas [1-5]:

Gastrointestinal
  • Oesophagitis
  • Gastritis
  • Peptic ulcer disease
  • Gallstone disease
  • Pancreatitis, bowel obstruction, appendicitis
  • Diverticular disease
  • Inflammatory bowel disease, ischaemic bowel, gastro-enteritis
  • Acute liver failure
  • Incarcerated hernia
  • Constipation
Gynaecologial
  • Ectopic pregnancy
  • Pelvic inflammatory disease
  • Ruptured ovarian cyst
Urological
  • Renal colic
  • Pyelonephritis
  • Urinary tract infection
  • Testicular torsion
  • Epididymo-orchitis
Vascular
  • Abdominal aortic aneurysm
Medical
  • Myocardial infarction
  • Pneumonia
  • Diabetic ketoacidosis
  • Hypercalcaemia
  • Mesenteric adenitis

aetiology_abdo_pain_pie

There are many causes of acute abdominal pain, although in terms of ED cases, the following approximate ratios are applicable [2,3]:

  • 40% will have a final diagnosis of non-specific abdominal pain (NSAP)
  • 20% appendicitis
  • 20% gallstone disease
  • 20% other causes
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