Epigastric pain DDX

  • GERD → Burning epigastric/chest pain worse after meals or lying flat with regurgitation, usually improves with antacids/PPI and normal workup.

  • Gastritis → Burning epigastric pain with nausea/bloating often related to NSAIDs or alcohol, differentiated by H. pylori testing or EGD.

  • Peptic Ulcer Disease (PUD) → Gnawing epigastric pain related to meals with possible melena/anemia, diagnosed with H. pylori testing and EGD.

  • Perforated Ulcer → Sudden severe epigastric pain with rigid abdomen/peritonitis, differentiated by free air on upright CXR or CT.

  • Pancreatitis → Severe epigastric pain radiating to the back with nausea/vomiting, diagnosed by lipase >3× normal.

  • Biliary Colic → Episodic RUQ/epigastric pain after fatty meals without fever, differentiated by gallstones on RUQ ultrasound.

  • Acute Cholecystitis → Persistent RUQ/epigastric pain with fever and Murphy sign, diagnosed by gallbladder wall thickening/pericholecystic fluid on ultrasound.

  • Choledocholithiasis → Epigastric/RUQ pain with jaundice and cholestatic LFTs, differentiated by biliary obstruction on MRCP/ERCP.

  • Ascending Cholangitis → Fever, jaundice, and RUQ/epigastric pain (Charcot triad), diagnosed with cholestatic labs and biliary dilation.

  • Hepatitis → Epigastric/RUQ discomfort with jaundice, fatigue, and dark urine, differentiated by markedly elevated AST/ALT.

  • ACS / Inferior MI → Epigastric pain with diaphoresis, dyspnea, or exertional symptoms especially in elderly/diabetics, diagnosed with EKG and troponins.

  • Aortic Dissection → Sudden tearing epigastric/chest pain radiating to the back, diagnosed by CTA.

  • Mesenteric Ischemia → Severe epigastric pain out of proportion to exam often with AFib history, differentiated by elevated lactate and CTA.

  • Functional Dyspepsia → Chronic epigastric discomfort/fullness with normal labs/imaging, diagnosed after exclusion of organic causes.

  • Gastroparesis → Early satiety, bloating, nausea, and epigastric discomfort especially in diabetics, diagnosed with gastric emptying study.

  • Gastroenteritis → Epigastric/crampy abdominal pain with vomiting and diarrhea, usually diagnosed clinically.

  • Small Bowel Obstruction → Crampy abdominal/epigastric pain with vomiting and distention, diagnosed by CT showing dilated bowel loops.

  • DKA → Epigastric pain with vomiting, polyuria, and altered mentation, differentiated by anion-gap acidosis and ketones.

  • AAA → Epigastric/back pain with hypotension or pulsatile mass, diagnosed rapidly with bedside ultrasound or CTA.

  • Esophagitis → Burning epigastric/chest pain with odynophagia, diagnosed by EGD.

  • Boerhaave Syndrome → Severe chest/epigastric pain after forceful vomiting with subcutaneous emphysema, diagnosed by CT chest/esophagram.

  • Hiatal Hernia → Postprandial epigastric discomfort and reflux symptoms, differentiated by barium swallow or EGD.

RUQ pain DDX

  • Acute Cholecystitis → Persistent RUQ pain with fever, nausea, and positive Murphy sign, diagnosed by RUQ ultrasound showing wall thickening/pericholecystic fluid.

  • Biliary Colic → Intermittent RUQ pain after fatty meals without fever or leukocytosis, differentiated by gallstones on RUQ ultrasound.

  • Choledocholithiasis → RUQ pain with jaundice and elevated bilirubin/ALP, diagnosed with MRCP or ERCP showing CBD stone.

  • Ascending Cholangitis → RUQ pain with fever and jaundice (Charcot triad), diagnosed by cholestatic labs and biliary dilation on imaging.

  • Hepatitis → RUQ pain/discomfort with fatigue, jaundice, nausea, and dark urine, differentiated by markedly elevated AST/ALT.

  • Liver Abscess → RUQ pain with fever, chills, and systemic illness, diagnosed by CT/ultrasound showing hepatic abscess.

  • Pancreatitis → Epigastric/RUQ pain radiating to the back with nausea/vomiting, diagnosed with elevated lipase.

  • Peptic Ulcer Disease → Burning epigastric/RUQ pain related to meals with possible GI bleeding, diagnosed with H. pylori testing and EGD.

  • Fitz-Hugh–Curtis Syndrome → RUQ pain in sexually active women with PID symptoms, differentiated by pelvic findings and STI testing.

  • Right Lower Lobe Pneumonia → RUQ pain with cough, fever, and hypoxia, diagnosed by chest X-ray infiltrate.

  • Pulmonary Embolism → Pleuritic RUQ/chest pain with tachycardia or hypoxia, diagnosed by CTA chest.

  • Pyelonephritis → RUQ/flank pain with fever, dysuria, and CVA tenderness, diagnosed by UA and urine culture.

  • Nephrolithiasis → Colicky RUQ/flank pain radiating to groin with hematuria, diagnosed by CT stone protocol.

  • Subphrenic Abscess → RUQ pain with fever and recent surgery/infection history, diagnosed by CT abdomen.

  • Congestive Hepatopathy → RUQ discomfort with JVD, edema, and heart failure signs, differentiated by hepatic congestion on imaging/labs.

  • Budd-Chiari Syndrome → RUQ pain with hepatomegaly and ascites, diagnosed by hepatic vein thrombosis on Doppler ultrasound/CT.

  • Herpes Zoster → Burning RUQ pain followed by dermatomal vesicular rash, diagnosed clinically.

  • ACS / Inferior MI → RUQ/epigastric discomfort with diaphoresis or exertional symptoms, diagnosed with EKG and troponins.

  • Aortic Dissection → Sudden severe RUQ/chest/back pain with pulse deficits or neurologic findings, diagnosed by CTA.

  • HELLP Syndrome (pregnancy) → RUQ pain in pregnancy with hypertension and elevated LFTs/platelets low, diagnosed with CBC/LFTs.

  • Gallbladder Cancer → Chronic RUQ pain with weight loss and jaundice, differentiated by mass/imaging abnormalities.

RUQ pain DDX

  • Splenic Infarct → Sudden LUQ pain often with AFib or hypercoagulable history, diagnosed by CT abdomen with contrast.

  • Splenic Rupture → Severe LUQ pain after trauma with hypotension or Kehr sign (left shoulder pain), diagnosed by FAST exam or CT.

  • Splenomegaly → LUQ fullness/discomfort with early satiety, differentiated by enlarged spleen on exam/imaging.

  • Pancreatitis → LUQ/epigastric pain radiating to the back with nausea/vomiting, diagnosed by elevated lipase.

  • Pancreatic Cancer → Persistent LUQ/epigastric pain with weight loss and jaundice, differentiated by CT pancreas protocol.

  • Gastritis → Burning LUQ/epigastric pain with nausea or NSAID/alcohol history, diagnosed with H. pylori testing or EGD.

  • Peptic Ulcer Disease → Gnawing LUQ/epigastric pain related to meals with possible melena, diagnosed by EGD and H. pylori testing.

  • Perforated Ulcer → Sudden severe LUQ/epigastric pain with rigid abdomen/peritonitis, differentiated by free air on imaging.

  • GERD → Burning upper abdominal/chest discomfort worse lying flat or after meals, improves with antacids/PPI.

  • Left Lower Lobe Pneumonia → LUQ pain with cough, fever, and hypoxia, diagnosed by chest X-ray infiltrate.

  • Pulmonary Embolism → Pleuritic LUQ/chest pain with tachycardia or dyspnea, diagnosed by CTA chest.

  • Pyelonephritis → LUQ/flank pain with fever, dysuria, and CVA tenderness, diagnosed by UA and urine culture.

  • Nephrolithiasis → Colicky LUQ/flank pain radiating to groin with hematuria, diagnosed by CT stone protocol.

  • Mesenteric Ischemia → Severe abdominal/LUQ pain out of proportion to exam often with AFib history, diagnosed by elevated lactate and CTA.

  • Small Bowel Obstruction → Crampy LUQ abdominal pain with vomiting and distention, diagnosed by CT showing dilated bowel loops.

  • IBS / Functional Dyspepsia → Chronic LUQ discomfort with normal labs/imaging and relation to stress or bowel habits, diagnosed clinically after exclusion.

  • Herpes Zoster → Burning LUQ pain followed by dermatomal vesicular rash, diagnosed clinically.

  • ACS / Inferior MI → LUQ/epigastric discomfort with diaphoresis or exertional symptoms, diagnosed with EKG and troponins.

  • Aortic Dissection → Sudden tearing chest/LUQ/back pain with pulse deficits, diagnosed by CTA.

  • Subphrenic Abscess → LUQ pain with fever and recent surgery/infection history, diagnosed by CT abdomen.

LLQ pain DDX**

  • Diverticulitis → LLQ pain with fever, constipation, or diarrhea in older adults, diagnosed by CT abdomen/pelvis showing colonic inflammation.

  • Constipation → Crampy LLQ discomfort with decreased bowel movements and bloating, differentiated by stool burden on exam/X-ray.

  • Colitis → LLQ pain with diarrhea and possible blood/mucus in stool, diagnosed by CT and stool studies.

  • Inflammatory Bowel Disease → Chronic LLQ pain with diarrhea, weight loss, and hematochezia, diagnosed with colonoscopy and biopsies.

  • Ischemic Colitis → Sudden LLQ pain with bloody diarrhea in older patients/vascular disease, diagnosed by CT or colonoscopy.

  • Small Bowel Obstruction → Crampy LLQ abdominal pain with vomiting and distention, diagnosed by CT showing dilated bowel loops.

  • Sigmoid Volvulus → Abdominal distention with LLQ pain and constipation/obstipation, differentiated by “coffee bean” sign on imaging.

  • Nephrolithiasis → Colicky LLQ/flank pain radiating to groin with hematuria, diagnosed by CT stone protocol.

  • Pyelonephritis → LLQ/flank pain with fever, dysuria, and CVA tenderness, diagnosed by UA and urine culture.

  • Urinary Tract Infection → Suprapubic/LLQ discomfort with dysuria and urinary frequency, diagnosed by urinalysis.

  • Inguinal Hernia → LLQ/groin pain with bulge worse on standing or coughing, diagnosed clinically or with ultrasound.

  • Ovarian Torsion → Sudden severe LLQ pain with nausea/vomiting in women, diagnosed by pelvic ultrasound with Doppler.

  • Ectopic Pregnancy → LLQ pain with vaginal bleeding and missed period, differentiated by positive β-hCG and transvaginal ultrasound.

  • Ovarian Cyst Rupture → Sudden unilateral LLQ pelvic pain often after exertion/intercourse, diagnosed by pelvic ultrasound.

  • Pelvic Inflammatory Disease → LLQ/pelvic pain with fever, discharge, and cervical motion tenderness, diagnosed clinically with STI testing.

  • Endometriosis → Cyclic LLQ/pelvic pain associated with menses and dyspareunia, diagnosed clinically/laparoscopy.

  • IBS → Chronic LLQ pain associated with bowel habit changes relieved by defecation, diagnosed clinically after exclusion.

  • Mesenteric Ischemia → Severe LLQ abdominal pain out of proportion to exam, diagnosed with elevated lactate and CTA.

  • Abdominal Aortic Aneurysm → LLQ/back pain with hypotension or pulsatile mass in older patients, diagnosed by ultrasound or CTA.

  • Herpes Zoster → Burning LLQ pain followed by dermatomal vesicular rash, diagnosed clinically.

RLQ pain DDX**

  • Appendicitis → RLQ pain migrating from periumbilical area with nausea, anorexia, and fever, diagnosed by CT abdomen/pelvis or ultrasound.

  • Mesenteric Adenitis → RLQ pain with recent viral illness and lymphadenopathy, differentiated by enlarged mesenteric nodes on CT.

  • Crohn Disease → Chronic RLQ pain with diarrhea, weight loss, and fistulas, diagnosed by colonoscopy with biopsies.

  • Cecal Diverticulitis → RLQ pain with fever and leukocytosis mimicking appendicitis, diagnosed by CT abdomen/pelvis.

  • Constipation → Crampy RLQ discomfort with decreased bowel movements and bloating, differentiated by stool burden on imaging/exam.

  • Small Bowel Obstruction → Crampy RLQ abdominal pain with vomiting and distention, diagnosed by CT showing dilated bowel loops.

  • Nephrolithiasis → Colicky RLQ/flank pain radiating to groin with hematuria, diagnosed by CT stone protocol.

  • Pyelonephritis → RLQ/flank pain with fever, dysuria, and CVA tenderness, diagnosed by UA and urine culture.

  • Urinary Tract Infection → Suprapubic/RLQ discomfort with dysuria and urinary frequency, diagnosed by urinalysis.

  • Inguinal Hernia → RLQ/groin pain with bulge worse on standing or coughing, diagnosed clinically or with ultrasound.

  • Ovarian Torsion → Sudden severe RLQ pelvic pain with nausea/vomiting, diagnosed by pelvic ultrasound with Doppler.

  • Ectopic Pregnancy → RLQ pain with vaginal bleeding and missed period, differentiated by positive β-hCG and transvaginal ultrasound.

  • Ovarian Cyst Rupture → Sudden unilateral RLQ pelvic pain often after intercourse/exertion, diagnosed by pelvic ultrasound.

  • Pelvic Inflammatory Disease → RLQ/pelvic pain with fever, discharge, and cervical motion tenderness, diagnosed clinically with STI testing.

  • Mittelschmerz → Mild unilateral RLQ pelvic pain occurring mid-cycle during ovulation, diagnosed clinically.

  • Testicular Torsion → RLQ/groin pain with acute testicular pain/swelling and absent cremasteric reflex, diagnosed by testicular ultrasound.

  • Epididymitis → RLQ/groin pain with scrotal swelling and dysuria, differentiated by testicular ultrasound and UA.

  • Mesenteric Ischemia → Severe RLQ abdominal pain out of proportion to exam, diagnosed with elevated lactate and CTA.

  • Abdominal Aortic Aneurysm → RLQ/back pain with hypotension or pulsatile mass, diagnosed by ultrasound or CTA.

  • Herpes Zoster → Burning RLQ pain followed by dermatomal vesicular rash, diagnosed clinically.

Suprapubic pain DDX**

  • Urinary Tract Infection (Cystitis) → Suprapubic pain with dysuria, urinary frequency, and urgency, diagnosed by urinalysis and urine culture.

  • Pyelonephritis → Suprapubic pain with fever, flank pain, nausea, and CVA tenderness, diagnosed by UA and urine culture.

  • Urinary Retention → Suprapubic pain/fullness with inability to void and distended bladder, diagnosed by bladder scan/post-void residual.

  • Nephrolithiasis → Suprapubic/groin pain with hematuria and colicky symptoms, diagnosed by CT stone protocol.

  • Interstitial Cystitis → Chronic suprapubic pain worsened by bladder filling and relieved with urination, diagnosed clinically after exclusion.

  • Prostatitis → Suprapubic/perineal pain with dysuria, fever, and tender prostate, diagnosed clinically with UA/culture.

  • Benign Prostatic Hyperplasia (BPH) → Suprapubic discomfort with weak stream, hesitancy, and incomplete emptying, differentiated by elevated post-void residual.

  • Pelvic Inflammatory Disease → Suprapubic/pelvic pain with vaginal discharge, fever, and cervical motion tenderness, diagnosed clinically with STI testing.

  • Ectopic Pregnancy → Suprapubic/pelvic pain with vaginal bleeding and missed period, diagnosed by β-hCG and transvaginal ultrasound.

  • Ovarian Torsion → Sudden severe suprapubic/unilateral pelvic pain with nausea/vomiting, diagnosed by pelvic ultrasound with Doppler.

  • Ovarian Cyst Rupture → Sudden pelvic/suprapubic pain often after exertion/intercourse, diagnosed by pelvic ultrasound.

  • Endometriosis → Cyclic suprapubic/pelvic pain associated with menses and dyspareunia, diagnosed clinically/laparoscopy.

  • Fibroids → Chronic suprapubic pressure/pain with heavy menstrual bleeding, differentiated by pelvic ultrasound.

  • Appendicitis (pelvic appendix) → Suprapubic pain with nausea, fever, and leukocytosis, diagnosed by CT abdomen/pelvis.

  • Diverticulitis → Suprapubic/LLQ pain with fever and bowel changes, diagnosed by CT abdomen/pelvis.

  • Constipation → Crampy suprapubic discomfort with bloating and decreased bowel movements, differentiated by stool burden on exam/imaging.

  • IBS → Chronic suprapubic abdominal pain associated with bowel habit changes relieved by defecation, diagnosed clinically after exclusion.

  • Bladder Cancer → Suprapubic discomfort with painless hematuria especially in smokers, diagnosed by cystoscopy and imaging.

  • Urethritis/STI → Suprapubic discomfort with dysuria and urethral discharge, diagnosed by STI testing.

  • Abdominal Wall Strain → Localized suprapubic pain worse with movement or palpation, diagnosed clinically.

Suprapubic pain DDX**

  • Gastroenteritis → Diffuse abdominal pain with nausea, vomiting, diarrhea, and sick contacts, usually diagnosed clinically.

  • Small Bowel Obstruction → Diffuse crampy abdominal pain with vomiting, distention, and obstipation, diagnosed by CT showing dilated bowel loops.

  • Large Bowel Obstruction → Diffuse abdominal pain with severe distention and constipation, differentiated by CT showing colonic dilation.

  • Mesenteric Ischemia → Severe diffuse abdominal pain out of proportion to exam often with AFib history, diagnosed by elevated lactate and CTA.

  • Peritonitis / Perforated Viscus → Sudden diffuse abdominal pain with rigid abdomen and rebound tenderness, diagnosed by free air on imaging.

  • Sepsis → Diffuse abdominal discomfort with fever, hypotension, and tachycardia, differentiated by infectious workup and elevated lactate.

  • Pancreatitis → Diffuse/epigastric abdominal pain radiating to the back with nausea/vomiting, diagnosed by elevated lipase.

  • DKA → Diffuse abdominal pain with vomiting, polyuria, and altered mentation, diagnosed by anion-gap metabolic acidosis and ketones.

  • Constipation → Diffuse crampy abdominal discomfort with bloating and decreased bowel movements, differentiated by stool burden on imaging/exam.

  • Ileus → Diffuse abdominal pain/distention with decreased bowel sounds after surgery or illness, diagnosed by diffuse bowel dilation without transition point.

  • IBS → Chronic diffuse abdominal pain associated with bowel habit changes relieved by defecation, diagnosed clinically after exclusion.

  • Inflammatory Bowel Disease → Diffuse abdominal pain with chronic diarrhea, weight loss, and hematochezia, diagnosed with colonoscopy and biopsies.

  • Colitis → Diffuse abdominal pain with diarrhea and possible blood/mucus in stool, diagnosed with CT and stool studies.

  • Ischemic Colitis → Diffuse/lower abdominal pain with bloody diarrhea in older vascular patients, diagnosed by CT or colonoscopy.

  • Appendicitis (early) → Initially diffuse/periumbilical pain migrating later to RLQ, diagnosed by CT or ultrasound.

  • Abdominal Aortic Aneurysm → Diffuse abdominal/back pain with hypotension or pulsatile mass, diagnosed by ultrasound or CTA.

  • Aortic Dissection → Sudden severe chest/back/abdominal pain with pulse deficits, diagnosed by CTA.

  • Opioid Withdrawal → Diffuse abdominal cramping with diarrhea, yawning, sweating, and myalgias, diagnosed clinically.

  • Sickle Cell Crisis → Diffuse abdominal pain with anemia and vaso-occlusive symptoms, diagnosed clinically with supportive labs.

  • Acute Intermittent Porphyria → Recurrent diffuse abdominal pain with neurologic or psychiatric symptoms, diagnosed by elevated urine porphobilinogen.

Acute Abdominal pain

yo M/F with PMH of , presenting with
 days constant/intermitent progressively worsening/improving

  • CC: Epigastric pain

  • PP:

  • PN:

  • pertinent SHx: tobacco, EtOH, drug use

Right Upper Quadrant (RUQ)

Pertinent Positives

  • Fever/chills → cholangitis/cholecystitis

  • Fatty food trigger → biliary colic

  • Jaundice/dark urine → obstruction/hepatitis

  • Murphy sign → cholecystitis

  • Radiation to back/right shoulder → biliary/pancreas

  • Cough/SOB → pneumonia/PE

Pertinent Negatives

  • No jaundice

  • No fever

  • No alcohol use

  • No chest pain

  • No urinary symptoms

Main Labs

  • CBC → infection

  • CMP/LFTs → biliary/hepatic pattern

  • Lipase → pancreatitis

  • Troponin/EKG → ACS

  • UA → renal source

  • Hepatitis panel if transaminitis

Main Imaging

  • RUQ ultrasound = FIRST LINE

  • CT abdomen/pelvis if unclear

  • MRCP/ERCP if obstruction concern

  • CXR if pulmonary symptoms

Left Upper Quadrant (LUQ)

Pertinent Positives

  • Pain radiating to back → pancreatitis

  • Trauma → splenic injury

  • Early satiety → splenomegaly

  • Fever/cough → pneumonia

  • AFib history → splenic infarct

Pertinent Negatives

  • No trauma

  • No alcohol use

  • No GI bleeding

  • No chest pain

Main Labs

  • CBC

  • CMP

  • Lipase

  • Troponin/EKG

  • Lactate if ischemia concern

Main Imaging

  • CT abdomen/pelvis

  • Lipase-directed pancreatitis workup

  • CXR if pulmonary symptoms

  • Ultrasound if splenic concern

Right Lower Quadrant (RLQ)

Pertinent Positives

  • Migration from periumbilical → appendicitis

  • Fever/anorexia → appendicitis

  • Diarrhea/weight loss → Crohn disease

  • Dysuria/hematuria → stone/UTI

  • Testicular pain → torsion

  • Vaginal bleeding/discharge → gyn pathology

Pertinent Negatives

  • No urinary symptoms

  • No vaginal bleeding

  • No diarrhea

  • No prior abdominal surgery

Main Labs

  • CBC

  • CMP

  • UA

  • β-hCG in women

  • CRP/ESR sometimes

  • STI testing if PID concern

Main Imaging

  • CT abdomen/pelvis = adults

  • Ultrasound = pregnancy/young pts

  • Pelvic ultrasound if ovarian concern

  • Testicular ultrasound if torsion concern

Left Lower Quadrant (LLQ)

Pertinent Positives

  • Fever → diverticulitis

  • Constipation/bloating → constipation/SBO

  • Bloody diarrhea → ischemic colitis/IBD

  • Dysuria/hematuria → stone/UTI

  • Weight loss/chronic diarrhea → IBD

Pertinent Negatives

  • No GI bleeding

  • No urinary symptoms

  • No prior diverticulitis

  • No vomiting

Main Labs

  • CBC

  • CMP

  • UA

  • Lactate if ischemia concern

  • Stool studies if diarrhea

Main Imaging

  • CT abdomen/pelvis = best initial

  • Colonoscopy later for IBD/ischemia (not acute diverticulitis)

Suprapubic Pain

Pertinent Positives

  • Dysuria/frequency → cystitis

  • Retention/incomplete emptying → BPH/retention

  • Vaginal discharge → PID

  • Vaginal bleeding → ectopic

  • Fever/flank pain → pyelo

Pertinent Negatives

  • No hematuria

  • No vaginal bleeding

  • No back pain

  • No urinary retention history

Main Labs

  • UA + urine culture

  • CBC

  • CMP

  • β-hCG

  • STI testing

Main Imaging

  • Bladder scan

  • Pelvic ultrasound

  • CT if unclear/stone concern

Epigastric Pain

Pertinent Positives

  • Burning/reflux → GERD

  • Worse with meals → PUD/gastritis

  • Radiates to back → pancreatitis

  • Exertional/diaphoresis → ACS

  • Melena → ulcer/GI bleed

  • Alcohol use → pancreatitis/gastritis

Pertinent Negatives

  • No chest pain

  • No NSAID use

  • No alcohol use

  • No GI bleeding

Main Labs

  • CBC

  • CMP/LFTs

  • Lipase

  • Troponin/EKG

  • Lactate if ischemia concern

Main Imaging

  • RUQ ultrasound

  • CT abdomen/pelvis

  • EGD later if chronic/alarm symptoms

Diffuse Abdominal Pain

Pertinent Positives

  • Vomiting/distention → SBO

  • Diarrhea → gastroenteritis/colitis

  • Pain out of proportion → mesenteric ischemia

  • Rigidity/rebound → perforation/peritonitis

  • Polyuria/polydipsia → DKA

  • Obstipation → obstruction

Pertinent Negatives

  • No fever

  • No GI bleeding

  • No prior surgery

  • No AFib history

Main Labs

  • CBC

  • CMP

  • Lipase

  • Lactate

  • VBG/ABG

  • Troponin/EKG

  • UA

  • β-hCG

  • Blood cultures if septic

Main Imaging

  • CT abdomen/pelvis with contrast = most important

  • Upright CXR if perforation concern

  • CTA if mesenteric ischemia/dissection concern

  • initial DATA:

  • pending DATA:

  • MEDS:

  • COURSE:

Plan :