Approach to Patients with Epigastric Pain

Emerg Med Clin North Am. 2016 May;34(2):191-210. doi: 10.1016/j.emc.2015.12.012. Epub 2016 Feb 23.

Abstract

Epigastric pain is an extremely common complaint in the emergency department and has an associated broad differential diagnosis. In the differential it is important to consider cardiac causes that may be mistaken for gastrointestinal disorders as well as various serious intra-abdominal causes. This article highlights the limitations in laboratory testing and guides providers through the appropriate considerations for advanced imaging. Special attention is focused on acute pancreatitis, esophageal emergencies, and peptic ulcer disease/gastritis and their associated complications.

Keywords: Acute pancreatitis; Boerhaave syndrome; Dyspepsia; Epigastric pain; Esophagitis; Food bolus impaction.

Publication types

  • Review

MeSH terms

  • Abdominal Pain* / diagnosis
  • Abdominal Pain* / therapy
  • Acute Disease
  • Anti-Ulcer Agents / therapeutic use
  • Chest Pain / diagnosis
  • Clinical Trials as Topic
  • Deglutition Disorders / diagnosis
  • Emergencies
  • Emergency Medicine / methods*
  • Empirical Research
  • Gastrointestinal Diseases* / diagnosis
  • Gastrointestinal Diseases* / therapy
  • Gastrointestinal Hemorrhage / diagnosis
  • Histamine Antagonists / therapeutic use
  • Muscle Relaxants, Central / therapeutic use
  • Proton Pump Inhibitors / therapeutic use

Substances

  • Anti-Ulcer Agents
  • Histamine Antagonists
  • Muscle Relaxants, Central
  • Proton Pump Inhibitors