Knowledge - Students should be able to be define and describe
- Pathophysiologic mechanisms of abdominal pain that mediate obstruction,
peritoneal irritation, referred pain, vascular insufficiency, motility dysfunction,
mucosal irritation and psychopathology; and that these varied mechanisms of abdominal pain
explain the differences in clinical presentations.
- Signs and symptoms of the common causes of abdominal pain, such as peptic ulcer
disease, dyspepsia, cholecystitis and biliary tract disease, pancreatitis, appendicitis,
diverticular disease, irritable bowel syndrome, intestinal obstruction, ileus and ischemic
- Signs and symptoms of the acute abdomen and differentiate this from chronic
abdominal pain situations.
Skills - Students should be able to:
- Obtain, document and present an appropriate and accurate medical history that
differentiates between the etiologies of abdominal pain. Understand that the broad
differential diagnosis in patients with abdominal pain can be narrowed significantly by a
careful medical history.
- Perform an accurate physical examination that recognizes peritoneal irritation,
guarding, abdominal tenderness, masses in the abdomen/pelvis/rectum, ascites,
organomegaly, vascular bruits.
- Generate a specific differential diagnosis after careful medical history and
- Recommend appropriate laboratory studies and be able to interpret results
obtained. Know when to order appropriate endoscopic procedure, ultrasound examination, CT
scans, nuclear medicine studies.
- Communicate with the patient and explain the results of the evaluation.
- Develop an appropriate treatment plan for the patient based on the diagnosis that
includes drug therapy (if indicated), consultation with subspecialists (GI medicine and
surgery), pain management, psychotherapy, patient education.
Attitudes and Professional Behaviors:
- Students should recognize the impact of chronic abdominal pain on patient's
lifestyle and its impact on the utilization of medical resources.
- Harrison's Principle of Internal Medicine B 14th Edition
Abdominal Pain, pages 65-68
Approach to the Patient with Gastrointestinal Disease, pages 1579-1582