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. Splinting of the abdomen occurs in peritonitis. The breathing will be predominantly thoracic. Distention may be due to free fluid or bowel obstruction.