The skin of the upper abdomen is first looked at for lesions, such as viral herpes zoster where visible redness and swelling are seen, and possibly substantial lesions such as costochondritis, or muscle strains or muscle contusions after exercise. In the case of lesions of organic organs in the abdominal cavity, usually lesions of the duodenum, gallbladder, and pancreas are common in the upper abdomen; lesions of the liver and colon may also be seen in the right upper abdomen; lesions of the spleen, tail of the pancreas, and colon and splenic flexure may also be seen in the left upper abdomen. If the pain is accompanied by fever and chills, it usually indicates the presence of infection and inflammation; if the pain is accompanied by violent vomiting, stopping the passage of gas and defecation, it is usually a symptom of early obstruction; if the pain is accompanied by a large amount of diarrhea, it usually indicates inflammation of the small intestine and colon; if the pain is lateral and there is radiating pain in the perineum, it may also be a urinary system disease such as kidney stones and hydronephrosis.