RIF pain

Possible diagnoses:

• Appendicitis
  • Periumbilical pain, N+V
  • USS first, then CT if this is inconclusive
• Renal colic
  • 'Loin to groin' pain
  • Non-contrast CT KUB is the gold standard
• Tubo-ovarian pathology

LIF pain

Possible diagnoses:

• Diverticulitis
  • Unremitting pain with associated tenderness
  • Consider CXR to look for perforation
  • CT with IV contrast is the investigation of choice
• Colitis
• Colorectal cancer
• Tubo-ovarian pathology
• Renal colic

Epigastric and RUQ pain

Possible diagnoses:

• Biliary colic
• Cholecystitis
  • US first line to assess bladder and biliary tree
  • CT can be false for calculi, but good for complications
  • MRI if biliary tree dilation
• Pancreatitis
  • Acute onset of severe central epigastric pain, poorly localised, exacerbated by supine positioning, may radiate to back
  • US used to identify gallstones as a possible cause, and for assessment of clinically similar aetiologies of an acute abdomen
  • CT
• Perforation
  • Erect CXR - pneumoperitoneum
  • CT - shows free fluid

Abdominal pain and distension

Possible diagnoses: