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Abdominal pain without any identifiable cause represents a frequent phenomenon in clinical practice and a challenge for the physician. Prior to establishing the diagnosis of non-specific abdominal pain it is crucial to exclude a variety of potential causes. The differential diagnosis is long and includes functional problems but also extra-intestinal pathologies including thoracic, neurogenic, and metabolic causes as well as intoxications. Moreover, an intra-abdominal pathology, particularly a malignancy, must be ruled out systematically prior to labeling a patient as having "non specific" abdominal pain.