Localized Acute Abdominal Pain(<72 hours) - Differential Diagnostic Algorithm

Look for surgical abdomen

Upper quadrant: R/O cardiac, pulmonary, renal, musculoskeletal causes

Lower quadrant: R/O genitourinary causes

Upper Quadrant - Peritoneal

 • Cholecystitis

 • Perforated ulcer

 • Pancreatitis (1,2)

 • Splenic rupture

Lower Quadrant - Non-Peritoneal

 • Urinary tract infection(upper, lower)

 • Ureteric colic

 • Irritable bowel syndrome

 • Psoas abscess

Right Upper Quadrant - Non-Peritoneal

 • Biliary Colic

 • Bowel Obstruction

 • Pyelonephritis 

 • Hepatitis

 • Hepatic Abscess

Epigastric - Non-Peritoneal

 • Peptic ulcer disease

 • Biliary Colic

 • Gastritis

 • Esophageal rupture

Left Upper Quadrant - Non-Peritoneal

 • Splenic infarct

 • Splenic abscess

 • Splenic rupture

Peritoneal - Bowel

 • Appendicitis

 • Diverticulitis

 • Incarcerated hernia

Pelvic / Adrenal - Bowel

 • Ectopic pregnancy

 • Ovarian torsion

 • Pelvic inflammatory disease

 • Salpingitis 



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