Lower Abdominal Pain

Emerg Med Clin North Am. 2016 May;34(2):229-49. doi: 10.1016/j.emc.2015.12.003.


Although most frequently presenting with lower abdominal pain, appendicitis, colitis, and diverticulitis can cause pain throughout the abdomen and can cause peritoneal and retroperitoneal symptoms. Evaluation and management of lower intestinal disease requires a nuanced approach by the emergency physician, sometimes requiring computed tomography, ultrasonography, MRI, layered imaging, shared decision making, serial examination, and/or close follow-up. Once a presumed or confirmed diagnosis is made, appropriate treatment is initiated, and may include surgery, antibiotics, and/or steroids. Appendicitis patients should be admitted. Diverticulitis and inflammatory bowel disease can frequently be managed on an outpatient basis, but may require admission and surgical consultation.

Keywords: Appendicitis; Crohn’s disease; Diverticulitis; Inflammatory bowel disease; Review; Ulcerative colitis.

Publication types

  • Review

MeSH terms

  • Abdominal Pain* / diagnosis
  • Abdominal Pain* / therapy
  • Colonic Diseases / diagnosis
  • Diagnosis, Differential
  • Emergency Service, Hospital
  • Gastrointestinal Diseases* / diagnosis
  • Gastrointestinal Diseases* / therapy
  • Humans
  • Magnetic Resonance Imaging / methods
  • Risk Factors
  • Tomography, X-Ray Computed / methods
  • Ultrasonography / methods