Diagnoses of Exclusion in the Workup of Abdominal Complaints

Joseph Wesley Watkins 4th; Zachary Bert Lewis

doi:10.1016/j.emc.2021.07.010

Diagnoses of Exclusion in the Workup of Abdominal Complaints

Emerg Med Clin North Am. 2021 Nov;39(4):851-863. doi: 10.1016/j.emc.2021.07.010. Epub 2021 Sep 2.

Authors

Joseph Wesley Watkins 4th¹, Zachary Bert Lewis²

Affiliations

¹ University of Arkansas for Medical Sciences, 4301 West Markham Street Slot 584, Little Rock, AR 72205, USA. Electronic address: Jwwatkins@uams.edu.
² University of Arkansas for Medical Sciences, 4301 West Markham Street Slot 584, Little Rock, AR 72205, USA.

PMID: 34600642
DOI: 10.1016/j.emc.2021.07.010

Abstract

Abdominal pain is a common complaint in the emergency department, comprising 8.8% of all visits. Despite advances in medicine and imaging, 20% to 30% of patients still leave the department without a definitive diagnosis, whichhis can be both distressing for patients and unsatisfying for providers. Diagnoses of exclusion can be perilous, and their application should be carefully considered in order to not overlook more emergent complaints. However, a working knowledge of diagnoses of exclusion can guide therapeutics and specialty referrals that can ultimately provide answers and relief to a patient population often at odds with available information and expectations.

Keywords: Abdominal migraine; Cyclic vomiting syndrome; Functional gallbladder; Gastroenteritis; Gastroparesis.

Publication types

Review

MeSH terms

Abdominal Pain / etiology*
Emergency Service, Hospital
Gastroenteritis / diagnosis
Gastrointestinal Diseases / diagnosis
Gastroparesis / diagnosis
Humans
Irritable Bowel Syndrome / diagnosis
Migraine Disorders / diagnosis
Vomiting / diagnosis

Supplementary concepts

Familial cyclic vomiting syndrome