http://www.merck.com/pubs/mmanual/section3/chapter25/25a.htm
" Although abdominal pain is common and often trivial, acute and severe pain nearly always is a symptom of intra-abdominal disease. It may be the sole indicator of the need for surgery. Whether the patient has a "surgical abdomen" must be swiftly decided. Precious time may be lost in useless testing: Gangrene and perforation of gut can occur as little as 6 hours after interruption of the intestinal blood supply from either a strangulating obstruction or an arterial embolus.
" Abdominal pain can be acute, in which the question of urgent surgery arises, or it can be chronic, in which case therapy (at least for a protracted time) is medical. Textbook descriptions of abdominal pain have severe limitations because individuals react to pain differently. Infants and children may be unable to localize their discomfort. Obese or elderly patients tend to tolerate pain better than others, but they have difficulty localizing the pain. On the other hand, hysterical patients tend to exaggerate symptoms."
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