Perspectives on acute abdominal pain in the college student: a clinically challenging conundrum

Abstract

Acute abdominal pain in the college student can be due to many causes, some of which are considered in this discussion. The key to an accurate diagnosis is a meticulous medical history, careful physical examinations repeated over time, and judicious use of laboratory and/or imaging studies. The medical history may indicate red fl ags that alert the astute clinician to which causes are benign and which ones indicate serious pathology. Particularly important is the location of the pain and how it may change over time. The challenging features presented by acute abdominal pain in the college student include fi ndings, such as guarding or rigidity, signifying acute appendicitis or peritonitis vs. negative palpatory fi ndings that are non-specifi c with minimal clinical value. Appropriate follow-up over time is a valued tool in the clinician ' s armamentarium in the evaluation and management of acute abdominal pain.