Case 1 – Acute Abdominal Pain


  • 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


  • 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


  • 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