The history taking follows the standard pattern. In particular, conditions likely to affect administration of anaesthesia have to be sought. History of nature and quantity of the last food intake has to be taken. The classical pain patterns are well known. The pain of a posterior ulcer or pancreatitis is felt in the epigastrium and radiates to the mid back.
Pancreatic pain is worse on lying down and improves on bending forward.
Biliary colic starts in the epigastrium or right hypochondrium and radiates to the interscapular area or the right shoulder. The pain can also felt in the left hypochondrium. Renal colic is felt in the back and the lumbar area with radiation to the groin and the testicles. The pulse is an under-rated vital sign. In contrast, the blood pressure may remain stable for a long time only to crash suddenly when decompensation occurs.