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RUQ
Hepatobiliary
Biliary colic
CBD obstruction (stone, tumour)
Hepatitis
Hepatic abscess/mass
Right subphrenic abscess
Gastrointestinal
Presentation of gastric, duodenal or pancreatic pathology
Hepatic flexure pathology (CRC, subcostal incisional hernia)
Genitourinary
Nephrolithiasis
Pyelonephritis
Renal: mass, ischemia, trauma
Cardiopulmonary
RLL pneumonia
Effusion/empyema
CHF (causing hepatic congestion and R pleural effusion)
MI
Pleuritis
Miscellaneous
Herpes zoster
Trauma
Costochondritis
RLQ
Gastrointestinal
Crohn’s disease
Tuberculosis of the ileocecal junction Cecal tumor
Intussusception
Mesenteric lymphadenitis (Yersinia) Cecal diverticulitis
Cecal volvulus
Hernia: femoral, inguinal obstruction, Amyand’s (and resulting cecal distention)
Gynecological
See ‘suprapubic’
Genitourinary
See ‘suprapubic’
Extraperitoneal
Abdominal wall hematoma/abscess Psoas abscess
EPIGASTRIC
Cardiac
Aortic dissection/ruptured AAA
MI
Gastrointestinal
Gastritis
GERD/esophagitis
Peptic ulcer disease
Pancreatitis
Mallory-Weiss tear
DIFFUSE
Gastrointestinal
Peritonitis
Early appendicitis, perforated appendicitis
Mesenteric ischemia Gastroenteritis/colitis
Constipation
Inflammatory bowel disease
Irritable bowel syndrome
Ogilvie’s syndrome
Cardiovascular/Hematological
Aortic dissection/ruptured AAA Sickle cell crisis
Genitourinary/Gynecological
Perforated ectopic pregnancy
PID
Acute urinary retention
Endocrinological
Carcinoid syndrome
Diabetic ketoacidosis
Addisonian crisis
Hypercalcemia
Other
Lead poisoning Tertiary syphilis
SUPRAPUBIC
Gastrointestinal (see RLQ/LLQ)
IBD
Gynecological
Ectopic pregnancy
PID
Endometriosis Threatened/incomplete abortion Hydrosalphinx/salpingitis
Ovarian torsion
Hemorrhagic fibroid
Tubo-ovarian abscess
Gynecological tumours
Genitourinary
Cystitis (infectious, hemorrhagic) Hydroureter/urinary colic
Epididymitis
Testicular torsion
Acute urinary retention
Extraperitoneal
Rectus sheath hematoma
LUQ
Pancreatic
Pancreatitis (acute vs. chronic)
Pancreatic pseudocyst
Pancreatic tumours
Gastrointestinal
Gastritis
Peptic ulcer disease
Splenic flexure pathology (e.g. CRC, ischemia)
Splenic
Splenic infarct/abscess Splenomegaly
Splenic rupture
Splenic aneurysm
Cardiopulmonary (see RUQ and Epigastric)
Genitourinary (see RUQ)
LLQ
Gastrointestinal
Diverticulitis
Diverticulosis Colon/sigmoid/rectal cancer
Fecal impaction
Proctitis (ulcerative colitis, infectious; i.e. gonococcus or chlamydia)
Sigmoid volvulus
Hernia
Gynecological
See ‘suprapubic’
Genitourinary
See ‘suprapubic’
Extraperitoneal
Abdominal wall hematoma/abscess
Psoas absces
s
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