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Differential Diagnosis of Abdominal pain and Flank Pain
Abdominal pain or flank pain due to urological disorders:
- Ureteral stone
- Pyelonephritis
- Renal abscess
- Retroperitoneal bleeding or hematoma
- Kidney infarction
- Renal vein thrombosis
- Urinary retention
- Acute prostatitis
- Testicular torsion
- Congenital disorders of the upper urinary tract
Abdominal pain due to liver disease:
- Cholelithiasis
- Cholecystitis
- Cholangitis
- Hepatitis
Abdominal pain due to intestinal diseases:
- Gastric ulcer or duodenal ulcer
- Appendicitis
- Ileus
- Diverticulitis
- Mesenteric infarction
- Crohn disease
Pancreatic diseases:
- Pancreatitis
Spleen diseases:
- Splenic infarction
- Spontaneous splenic rupture
Abdominal pain or flank pain due to diseases of the great arteries:
- Aortic aneurysm
- Renal artery aneurysm
- Mesenteric artery occlusion/stenosis
Abdominal pain due to gynecological diseases:
- Pelvic inflammatory disease
- Ectopic pregnancy
- Ovarian torsion
- (Ruptured) ovarian cyst
- Mittelschmerz
Diseases of the abdominal wall:
- Incarcerated hernia
- Rectus sheath or abdominal wall hematoma
Abdominal pain or flank pain due to thoracic diseases:
- Pneumonia
- Pulmonary embolism
- Pleurisy
- Myocardial ischemia
- Esophageal rupture
- Esophageal spasm
- Gastro-esophageal reflux disease (GERD)
Abdominal pain due to metabolic diseases:
- Porphyria
- Ketoacidosis in diabetes mellitus
- Hemochromatosis
- Hyperparathyroidism
- Acute hemolysis
- Uremia
Abdominal pain or flank pain due to diseases of the nervous system:
- Back pain
- Herpes zoster
- Herniated disc
- Neuralgia
Diagnostic Workup of sudden Abdominal Pain or Flank Pain
- Medical history and physical examination
- Urine sediment
- Laboratory tests: blood count, GOT, GPT, gamma-GT, CK, CRP, electrolytes, creatinine, urea, lipase
- ECG
- Imaging: depending on the symptoms and severity: Ultrasound imaging, abdominal X-ray, chest X-ray and/or abdominal CT scan (with or without contrast medium)
- Diagnostic laparoscopy or laparotomy if acute intestinal or vascular disease is suspected
- Gastroscopy if melena or blood vomiting is present
Urologic Surgery | Index | Adrenal tumor |
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References
Siegenthaler, W. (ed.) Differentialdiagnose innerer KrankheitenGeorg Thieme Verlag, Stuttgart, New York., 1988
Deutsche Version: Differentialdiagnose von Bauchschmerzen und Flankenschmerzen
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