The most logical question ever, “Where does it hurt?”

Different regions of the abdomen contain different organs. If a patient complains of right upper quadrant pain, the patient is probably having a problem their liver or gallbladder. If the patient is having pain around their naval, the patient could be experiencing appendicitis.

The basics of physical examination

When clinicians don’t know how to physically assess something, the basics of physical examination should always be considered:

• Inspection – Look at the area where the patient indicates is painful. Does it look red or blotchy? Is it distended or otherwise discolored? A normal finding would indicate the patient’s abdomen is neither distended, rigid, or discolored.
• Palpation – Touch the area where the patient indicates is painful. If the pain increases when it is touched, the patient is experiencing tenderness. If the pain increases after the area is touched, the patient might be experiencing rebound tenderness. A normal finding would indicate a patient whose abdomen is neither tender or demonstrates rebound tenderness.
• Auscultation – Listen to the area with a stethoscope. In the case of the abdomen, listening for the presence or absence of bowel sounds can be helpful in understanding if the patient is suffering from a bowel obstruction.
• Percussion – Tapping on an area and listening for hyperresonate or hyporessonate sounds can be helpful in determining if fluid or air is trapped beneath the surface of the skin or is filling up a body cavity.

Ask questions about additional symptoms

Additional finding that would support a diagnosis or differential diagnosis could include:

• Nausea
• Vomiting
• Diarrhea
• Blood in stool
• Blood in urine
• Pain
• Signs of shock (no radial pulse)
• Fever