Acute central abdominal pain

Some differential diagnoses and typical outline evidence

Small bowel obstruction	Suggested by: vomiting, constipation with complete obstruction.
	Confirmed by: AXR shows small bowel loops and fluid levels.
	Management: OHCM p492.
Crohn's disease	Suggested by: chronic diarrhoea with abdominal pain, weight loss, palpable RLQ mass or fullness, mouth ulcers.
	Confirmed by: colonoscopy with biopsy, barium studies showing ‘skip lesions’, string sign in advanced cases.
	Management: OHCM p246.
Mesenteric artery occlusion	Suggested by: vomiting, bowel urgency, melaena, diarrhoea.
	Confirmed by: mesenteric angiography, exploratory laparotomy.
	Management: OHCM p488.
Abdominal aortic dissection	Suggested by: tearing pain ± shock ± hypotension and peripheral cyanosis.
	Confirmed by: ultrasound or CT abdomen.
	Management: OHCM p480.