Differential Diagnosis Of Acute Abdominal Pain

Here’s a sordid acronym: BITCH.

Acute abdominal pain

  • Bleeding (haemorrhage)
  • Inflammation
  • Twisting (torsion, leading to ischaemia)
  • Congestion (obstruction)
  • Hole (perforation)

Bleeding

  • Ruptured AAA, ovarian cyst, ectopic pregnancy or abdominal organ
  • Leads to haemoperitoneum, meaning blood in the abdominal cavity

Inflammation

  • -itis of any organ in the abdominal area
  • Just think of the anatomy in the region to come up with possibilities
  • Appendicitis is the most likely surgical cause, while gastroenteritis is a common ailment of the masses

Twisting

  • Sigmoid volvulus
  • Torsion of gonadal structures (ovaries or testes)

Congestion

  • Things that involve blockage
  • Constipation
  • Intestinal obstruction, ureteric obstruction from renal calculus or urinary retention
  • Mesenteric ischaemia

Hole

  • Perforated gastrointestinal structure
  • Gastric or duodenal ulcers
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