Upper Abdominal Pain
COVID-19 clinical presentation <div class="redbox"> <p style="text-size:12px;">COVID-19 can present with a myriad of symptoms so should probably be on most differential diagnosis lists during the pandemic</p> <li><a href="https://productivemedic.com/covid-remote-assessment/" target="_blank">COVID assessment, DDx and complications</a></li> <li><a href="https://www.google.com/imgres?imgurl=https%3A%2F%2Ff6publishing.blob.core.windows.net%2F2ab0884c-0618-4586-aaf1-41004e6ad656%2FWJCC-8-3956-g002.png&imgrefurl=https%3A%2F%2Fwww.wjgnet.com%2F2307-8960%2Ffull%2Fv8%2Fi18%2F3956.htm&tbnid=I0G0VvXcx_akPM&vet=12ahUKEwj1_43FsrnuAhUH-YUKHSoZAFQQMygYegUIARCwAQ..i&docid=IBDQMbzRItpvKM&w=3307&h=2168&q=covid%2019%20presentation&safe=strict&ved=2ahUKEwj1_43FsrnuAhUH-YUKHSoZAFQQMygYegUIARCwAQ" target="_blank">Clinical presentation summary infographic</a></li> <div>
*Common causes
*Must not miss!
*Easily missed
Red flags
  • Acute severe pain
  • Weight loss
  • Systemic features (fever, night sweats, anorexia)
  • New onset persistent Dyspepsia > 50 years old
  • Dysphagia
  • Persistent vomiting
  • Haematemesis/Melaena
  • Supraclavicular lymph nodes
  • Abdominal swelling/mass
  • Anaemia
  • Raised inflammatory markers
  • Known abdominal aortic aneurysm
  • Past history of cancer
  • Family history of cancer
Investigations to consider
  • FBC, CRP/ESR
  • U&Es, LFTs, Blood glucose, Bone profile
  • Serum Amylase
  • Coeliac screen
  • FIT and Calprotectin
  • Urinalysis/MSU
  • Pregnancy test
  • ECG
  • AXR, KUB/ IVU, CXR
  • USS
  • OGD
  • Barium swallow
  • Small bowel enema
  • CT
  • Angiography
* DDx list disclaimer: please read
  • These lists could never be comprehensive and remain practical to use during the consultation. We have included conditions that we think will cover the vast majority of primary care presentations for any given symptom. This does not mean other conditions, red flags and investigations should not be considered.
  • Each list is provided as a brief reminder only and is presented in no particular order. The authors have used editorial licence to allow quicker access during the consultation and to prevent duplication.
  • We feel that the "Must not Miss" conditions should always appear at the top of your differential diagnosis list. The consequences of missing a diagnosis from within this category carry significant morbidity and mortality risks to your patient.
  • Many diagnoses are not obvious or apparent at the initial presentation. It may be appropriate to share your diagnostic uncertainty with patient, and also provide specific guidance (safety netting) on when and where patients should seek further advice and follow up.