Relevant Points in the history...

Relevant Points in the history of patients with acute abdominal pain.

• Ask the patient what the complaint is.
• Determine that onset, constancy, relieving factors, and exacerbathing factors.
• Age is important in predicting the pathology.
• Pain is a most important symptom. Determine its onset , character, site, severity, movement. Ask if  anything relieves or exacerbates the pain, eg- movement or coughing  in peritonitis, food in peptic ulcer disease.
• Vomiting. Note onset and time, type, presistence, content. Did pain precede vomiting? If so the cause of vomiting is usually surgical.
• Diarrhoeal/constipation.These may be relevant in cases of intermittent or complete intestinal obstruction.
• Temperature. Is the patient pyrexial? Are there rigors? These suggest bacterial infection.
• Past medical history. Ask about previous operations, disease, family history, recent injury, menstrual periods.
• Drugs. Ask about current or recent medication. Specifically ask about hypoglycaemics, steriods, sedatives, hypotensives, non-steroidal anti-inflammatory drugs, anticoagulants, antibiotics, and cardiac drugs.
• In patients who have sustained truma, get details of what happened from the patient or other witnesses. Start resuscitation if required at the same time.