Emerg Med Clin North Am. 2021 Nov;39(4):851-863. doi: 10.1016/j.emc.2021.07.010.Epub 2021 Sep 2.

Joseph Wesley Watkins 4th ¹, Zachary Bert Lewis ²

Author information

¹University of Arkansas for Medical Sciences, 4301 West Markham Street Slot 584, Little Rock, AR 72205, USA. Electronic address: Jwwatkins@uams.edu.

²University of Arkansas for Medical Sciences, 4301 West Markham Street Slot 584, Little Rock, AR 72205, USA.

Abstract

Abdominal pain is a common complaint in the emergency department, comprising 8.8% of all visits. Despite advances in medicine and imaging, 20% to 30% of patients still leave the department without a definitive diagnosis, whichhis can be both distressing for patients and unsatisfying for providers. Diagnoses of exclusion can be perilous, and their application should be carefully considered in order to not overlook more emergent complaints. However, a working knowledge of diagnoses of exclusion can guide therapeutics and specialty referrals that can ultimately provide answers and relief to a patient population often at odds with available information and expectations.