Differential Diagnosis of Acute Upper Abdominal Pain

Gallstone Colic Jaundice Biliary Colic Pain in Epigastrium or Right Upper Quadrant radiating to lower right Scapula No fever Tenderness in The RU

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Gallstone Colic

Jaundice

Biliary Colic

Pain in Epigastrium or Right Upper Quadrant radiating to lower right Scapula

No fever

Tenderness in The RUQ

WCC Normal

   Confirmation : Ultrasonography of Gallbladder and Biliary Ducts

 

Acute Cholecystitis 

Fever

Jaundice

 Positive Murphy Sign

WCC : Leukocytosis

Confirmation US Gall bladder and Biliary Ducts

Acute Pancreatitis

Pain radiating straight through to the back

Pain better on sitting or leaning forward

general Abdominal tenderness

reduced bowel sounds

Confirmation : Serum Amylase or Serum Lipase and CT Pancreas

Acute Cholangitis

Charcot Triad : Fever , RUQ painand Jaundice

Hypotension

WCC : Leucocytosia

Confirmation : US gallbladder , Biliary Ducts and Blood Cultures

 

Gastric Carcinoma

Anorexia

Fullness

Pain

Virchow Node

Confirmation : Upper GIT endoscopy with Biopsy

 

Gastritis 

Epigastric Pain

Dull

Burning Discomfort

Nocturnal Pain

Confirmation : Esophagogastoscopy , Barium Meal and PH study

 

Hiatus Hernia 

Heart Burn  worsens by Lying Down

relieved by Antacids

Acute Coronary Syndrome 

 

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