关键词: 腹痛, 中枢介导的腹痛综合征, 全科医生, 临床5问思维法, RICE问诊

Abstract: This article introduces the encountering of a patient with abdominal pain by a general practitioner general using John Murtagh's safe diagnostic strategy，which consists of five questions：（1）What are the common causes of abdominal pain？（2）What severe disorders must not be overlooked？（3）What conditions that may be associated with abdominal pain are often missed？（4）Could the patient have a concealing illness？（5）Is the patient attempting to say something？After detailed consultation，comprehensive physical examination and laboratory test，the patient was diagnosed with centrally mediated abdominal pain syndrome.The revelation of this case is：（1）Abnormal pain associated with a life-threatening organic lesion should be differentiated from simple abdominal pain first.（2）Using comprehensive clinical perspectives in primary care practice may reduce the possibilities of missed diagnosis and misdiagnosis，and find the hidden causes of gastrointestinal functional diseases.Through eliminating the unnecessary concerns of patients，adjusting treatment，and delivering home-based health care，satisfactory results may be achieved.

Key words: Abdominal pain, Centrally mediated abdominal pain syndrome, General practitioners, Clinical 5-question thinking method, RICE inquiring