Features of high risk abdominal pain

History

Age over 65

Immunocompromised (eg, HIV, chronic glucocorticoid treatment)

Alcoholism (risk of hepatitis, cirrhosis, pancreatitis)

Cardiovascular disease (eg, CAD, PVD, hypertension, atrial fibrillation)

Major comorbidities (eg, cancer, diverticulosis, gallstones, IBD, pancreatitis, renal failure)

Prior surgery or recent GI instrumentation (risk of obstruction, perforation)

Early pregnancy (risk of ectopic pregnancy)

Pain characteristics

Sudden onset

Maximal at onset

Pain then subsequent vomiting

Constant pain of less than two days duration

Exam findings

Tense or rigid abdomen

Involuntary guarding

Signs of shock

High_risk_abd_pain.htm

CAD: coronary artery disease; HIV: human immunodeficiency virus; IBD: inflammatory bowel disease; PVD: peripheral vascular disease.

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