History
- Onset and duration of abdominal pain
- Location of pain
- Alleviating factors
- Aggravating factors
- Progression of pain
- Quality of pain
- Radiation of pain
- Severity of pain
- Associated nausea and vomiting
- Fever
- Changes in bowel habit
- Blood in stools
- Menstruation history
- Urinary symptoms
- Sexual history and use of contraception
- Previous pregnancies
- Previous abdominal surgery
- Recent changes in diet
- Travel history
- Infectious contacts
Physical Examination
Inspection/Auscultation
- Comments on patient’s position on the examination table and drapes patient appropriately
- Inspects the abdomen for masses, scars
- Auscultates in all four quadrants of the abdomen
Percussion/Palpation
- Uses light and deep palpation to examine for tenderness
- Monitors patient’s reaction to palpation, comments on guarding
- Assesses for rebound tenderness in the right lower quadrant
- Notes tenderness at McBurney’s point
- States that they would perform a digital rectal examination as part of the abdominal examination
Special Maneuvers
- Assesses for Murphy’s Sign
- Assesses for Rosving’s sign
- Assesses for Psoas sign
Case 1 – Acute Abdominal Pain