Abdominal Pain: Just Gas Or An Emergency?
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Ectopic (tubal) pregnancy:

A tubal pregnancy is always a medical emergency, and nearly always requires surgery.  This is a pregnancy that has implanted outside the womb-generally in a fallopian tube, where it cannot grow or thrive.  Once the pregnancy reaches a certain size, it can rupture, putting a woman at great risk for hemorrhage, shock, and other complications. In fact, ectopic pregnancy is the leading cause of first trimester related death.

Ectopic pregnancy occurs in approximately one in fifty pregnancies.  Risk factors include having had a previous tubal pregnancy, having an IUD in place, having had previous pelvic surgeries or infections, or having endometriosis.  Warning signs include a crampy pain with tenderness on one side of the lower abdomen, which can spread throughout the entire belly.  Pain generally increases with any movement.  Often women have spotting, some signs of early pregnancy (e.g. nausea, breast swelling, missed period), and may feel dizzy or faint.  Some patients confuse the spotting with a light period, and fail to consider that they may be pregnant.  But if you have these symptoms, get to an emergency room immediately and be sure to tell them you think you may have a tubal pregnancy.  Immediate diagnosis and surgery should prevent life-threatening complications and may protect future fertility.

Appendicitis:

Appendicitis is probably the first thing women think about when they have a severe pain in the side or lower abdomen, especially on the right.  This condition affects approximately one in 500 adults, but it can affect children as well.  This is an infection of a vestigial part of the colon usually caused by trapped food or stool.  Warning signs can be vague, often beginning as a slight discomfort around the belly button, but progressing to a severe, sharp pain in the lower right side of the abdomen.  This can be accompanied by lost appetite, nausea and vomiting, constipation, and a low-grade fever.  Generally patients do not want to move, preferring to lie in the fetal position.  If you have these symptoms, get to an emergency room immediately for an evaluation.  While there is no specific test for appendicitis, your exam and other tests may suggest that exploratory surgery is necessary (often through a laparascope using a small incision below your belly button).  Because of this, surgery is often performed when the diagnosis is not appendicitis after all and your surgeon may remove your normal appendix anyway.  This is entirely acceptable and may prevent future confusion or emergency room visits.