Patients also may report pain similar to pain that occurs with renal colic. Biliary colic Clinical presentation is pain in the right upper quadrant or epigastric pain, which may be postprandial. Pain may be referred to the right scapula. Renal colic Patients report severe pain in the flank that may radiate toward the groin. Blunt or penetrating abdominal trauma Patients usually have an acute injury.
Patients can present with splenic injuries several days after the initial injury.
A pregnancy test is invaluable in determining the etiology of abdominal pain in females of childbearing age. The Murphy sign may be observed at ultrasonography. Palpation with the probe is particularly helpful to the physician sonographer in differentiating right lower quadrant pain from pain of pelvic origin in female patients. Ultrasonography may be indicated for the evaluation of AAA, the biliary tract, acute cholecystitis, the kidneys and urinary tract, hydronephrosis, blunt or penetrating trauma, or appendicitis. Para-aortic nodes may anteriorly displace the aorta, causing the sensation of a pulsatile mass on physical examination.