Differential Diagnosis

Generalized Pain: Intestinal infarction, peritonitis, obstruction, diabetic ketoacidosis, sickle crisis, acute porphyria, penetrating posterior duodenal ulcer, psychogenic pain.

Right Upper Quadrant: Cholecystitis, cholangitis, hepatitis, gastritis, pancreatitis, hepatic metastases, gonococcal perihepatitis (Fitz-Hugh-Curtis syndrome), retrocecal appendicitis, pneumonia, peptic ulcer.

Epigastrium: Gastritis, peptic ulcer, gastroesophageal reflux disease, esophagitis, gastroenteritis, pancreatitis, perforated viscus, intestinal obstruction, ileus, myocar-dial infarction, aortic aneurysm.

Left Upper Quadrant: Peptic ulcer, gastritis, esophagitis, gastroesophageal reflux, pancreatitis, myocardial ischemia, pneumonia, splenic infarction, pulmonary embolus.

Left Lower Quadrant: Diverticulitis, intestinal obstruction, colitis, strangulated hernia, inflammatory bowel disease, gastroenteritis, pyelonephritis, nephrolithiasis, mesenteric lymphadenitis, mesenteric thrombosis, aortic aneurysm, volvulus, intussusception, sickle crisis, salpingitis, ovarian cyst, ectopic pregnancy, endometriosis, testicular torsion, psychogenic pain.

Right Lower Quadrant: Appendicitis, diverticulitis (redundant sigmoid) salpingitis, endometritis, endometriosis, intussusception, ectopic pregnancy, hemorrhage or rupture of ovarian cyst, renal calculus.

Hypogastric/Pelvic: Cystitis, salpingitis, ectopic pregnancy, diverticulitis, strangulated hernia, endometriosis, appendicitis, ovarian cyst torsion; bladder distension, nephrolithiasis, prostatitis, malignancy.

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