{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T20:44:16Z","timestamp":1765831456871,"version":"3.48.0"},"reference-count":23,"publisher":"BMJ","issue":"6","license":[{"start":{"date-parts":[[2020,6,20]],"date-time":"2020-06-20T00:00:00Z","timestamp":1592611200000},"content-version":"unspecified","delay-in-days":19,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"JPCA Project for Developing Future Leaders in Research","award":["2016B003"],"award-info":[{"award-number":["2016B003"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2020,5,29]]},"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Abdominal pain is one of the most frequent chief complaints in primary care settings. The aim of the present study was to determine the positive likelihood ratios (PLRs) and negative likelihood ratios (NLRs) of the relationships between the sites of abdominal pain and the organs involved.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Prospective observational study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>A single tertiary centre, a university hospital in Japan.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>A total of 2591 new outpatients visited the Department of General Medicine at a university hospital from April 2017 to March 2018. Of these, 326 patients aged \u226520 years with abdominal pain were enrolled.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Sites of abdominal pain were classified into 11 categories including nine different abdominal sections, \u2018generalised abdomen\u2019 and \u2018site-indeterminate\u2019. The PLRs between \u2018right subcostal\u2019 and \u2018liver and biliary tract\u2019; between \u2018right subcostal\u2019 and \u2018musculoskeletal\u2019 ; between \u2018epigastric\u2019 and \u2018oesophagus, stomach and duodenum\u2019; between \u2018right or left flank\u2019 and \u2018urinary tract\u2019; between \u2018left flank\u2019 and \u2018dermatological\u2019; and between \u2018mid-lower\u2019 and \u2018intestinal\u2019 ranged from 2.17 to 4.14. The PLRs between \u2018epigastric\u2019 and \u2018urinary tract\u2019; between \u2018mid-lower\u2019 and \u2018liver and biliary tract\u2019; between \u2018periumbilical\u2019 and \u2018urinary tract\u2019; and between \u2018generalised abdomen\u2019 and \u2018oesophagus, stomach and duodenum\u2019 were low, ranging from 0.17 to 0.25. The NLR ranged from 0.5 to 1.5, excluding the relationship between \u2018left flank\u2019 and \u2018dermatological\u2019.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The presence of pain at right subcostal, epigastric, right or left flank and mid-lower sites might be useful for identifying the organs involved. Additionally, the presence of pain at mid-lower, epigastric, periumbilical and generalised abdominal sites might be helpful for denying the involvement of some organs. Some sites of abdominal pain can be indicative of the organs involved.<\/jats:p>\n                    <jats:p>\n                      <jats:bold>Trial registration number<\/jats:bold>\n                    <\/jats:p>\n                    <jats:p>UMIN000037686<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2019-034446","type":"journal-article","created":{"date-parts":[[2020,6,23]],"date-time":"2020-06-23T02:09:55Z","timestamp":1592878195000},"page":"e034446","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Relationships between sites of abdominal pain and the organs involved: a prospective observational study"],"prefix":"10.1136","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5143-8665","authenticated-orcid":false,"given":"Shun","family":"Yamashita","sequence":"first","affiliation":[{"name":"General Medicine, Saga University Hospital, Saga, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masaki","family":"Tago","sequence":"additional","affiliation":[{"name":"General Medicine, Saga University Hospital, Saga, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naoko E","family":"Katsuki","sequence":"additional","affiliation":[{"name":"General Medicine, Saga University Hospital, Saga, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomoyo M","family":"Nishi","sequence":"additional","affiliation":[{"name":"General Medicine, Saga University Hospital, Saga, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shu-ichi","family":"Yamashita","sequence":"additional","affiliation":[{"name":"General Medicine, Saga University Hospital, Saga, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2020,6,22]]},"reference":[{"key":"2025121512415744000_10.6.e034446.1","doi-asserted-by":"crossref","first-page":"27","DOI":"10.2188\/jea.7.27","article-title":"The relationship between abdominal pain regions and specific diseases: an epidemiologic approach to clinical practice","volume":"7","author":"Yamamoto","year":"1997","journal-title":"J Epidemiol"},{"key":"2025121512415744000_10.6.e034446.2","first-page":"341","article-title":"Acute abdominal pain","volume":"2","author":"Stone","year":"1998","journal-title":"Lippincotts Prim Care Pract"},{"key":"2025121512415744000_10.6.e034446.3","first-page":"1","article-title":"National Hospital ambulatory medical care survey: 2004 emergency department summary","volume":"372","author":"McCaig","year":"2006","journal-title":"Adv Data"},{"key":"2025121512415744000_10.6.e034446.4","first-page":"1","article-title":"National Hospital ambulatory medical care survey: 2005 emergency department summary","volume":"386","author":"Nawar","year":"2007","journal-title":"Adv Data"},{"key":"2025121512415744000_10.6.e034446.5","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9610(76)90101-X"},{"key":"2025121512415744000_10.6.e034446.6","first-page":"5","article-title":"Acute abdominal pain in adults","volume":"85","author":"Miettinen","year":"1996","journal-title":"Ann Chir Gynaecol"},{"key":"2025121512415744000_10.6.e034446.7","doi-asserted-by":"publisher","DOI":"10.1620\/tjem.233.9"},{"key":"2025121512415744000_10.6.e034446.8","doi-asserted-by":"publisher","DOI":"10.1016\/0735-6757(95)90204-X"},{"key":"2025121512415744000_10.6.e034446.9","doi-asserted-by":"crossref","unstructured":"De Simone B , Ansaloni L , Sartelli M , et al . 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