| Quality of pain | Selected examples of diseases |
| Dull, poorly localized, crampy, and midline (visceral pain) | Appendicitis | - Subtle, gradually worsening, vague periumbilical pain
- Subsequent migration to sharp, right lower quadrant pain (becomes parietal pain)
- Nausea and vomiting follows onset of pain
|
| Small bowel obstruction | - Periumbilical, crampy, paroxysmal pain
- Associated with nausea, vomiting, obstipation, abdominal distension
|
| Distinct, sharp, and localized (parietal pain) | Ovarian cyst rupture | - Sudden onset of unilateral lower abdominal pain
- Pain often begins during strenuous physical activity (eg, exercise or sexual intercourse)
- May be accompanied by light vaginal bleeding
|
| Diverticulitis | - Left lower quadrant (if sigmoid colon is involved) constant pain that develops over several days
- May have localized peritoneal signs (eg, localized guarding and rebound tenderness)
- Often accompanied by nausea, vomiting, and a change in bowel habits
|
| Pain that waxes and wanes in intensity (colicky pain) | Nephrolithiasis | - Severe, sudden-onset abdominal or flank pain
- Paroxysms of severe pain usually last 20 to 60 minutes
- Radiates to the flank or groin
- Associated with hematuria in most patients
|
| Burning pain | Gastroesophageal reflux disease | - Burning sensation, commonly retrosternal and occurring in the postprandial period
- May be associated with regurgitation (perception of flow of refluxed gastric content into the mouth or hypopharynx)
|
| Tearing pain | Aortic dissection | - Acute-onset pain commonly in chest or back
- Pain can extend into abdomen if abdominal aorta involved or mesenteric vasculature is compromised
|
