Assessing and evaluating the patient

The ideal starting point for discussion is the patient who presents to hospital with severe abdominal pain and evidence of intra-abdominal inflammatory disease (see Figure 1.1). The characteristics of abdominal pain that are most revealing are the time of onset, the location and radiation of the pain, and any provocative or palliative factors. Associated symptoms that should also be elicited are different types of pain (eg, colic or constant), nausea or vomiting, fever, anorexia, diarrhea or bloody stools, and dysuria.