Protocolo diagnóstico de la epigastralgia aguda

Abstract

Introduction Acute epigastric pain is one of the most frequent reasons for consultation in the Emergency Department and also in Primary Care. In addition there is a wide differential diagnosis, not only from the gastrointestinal tract, as possible causes for the pain. Aetiology The initial assessment should focus the study on severe and life threatening causes as acute mesenteric ischemia, perforation, obstruction and local inflammatory conditions. Furthermore some extraintestinal causes as acute coronary syndrome and pulmonary thromboembolism may be considered. Diagnostic process Once the patient is stabilized and these causes are excluded, the clinical information should guide further examinations in order to obtain a correct diagnosis. In this publication we have summarized the most important clinical data and findings on physical examination signs that should be considered in all cases. In addition we have carried out an approximation of the most common investigations in this setting. Here we emphasize the importance of the multidisciplinary work involved in the diagnosis and treatment of such cases in daily practice.