Abdominal pain

From Academic Kids

Abdominal pain can be one of the symptoms associated with transient disorders or serious disease. Making a definitive diagnosis of the cause of a person's abdominal pain can be quite difficult, because so many diseases can result in this symptom.

Contents

Introduction

Abdominal pain is traditionally described by its chronicity (acute or chronic), its progression over time, its nature (sharp, dull, colicky), its distribution (by various methods, such as abdominal quadrant (left upper quadrant, left lower quadrant, right upper quadrant, right lower quadrant) or other methods that divide the abdomen into nine sections), and by characterization of the factors that make it worse, or alleviate it.

Approaches

Due to the many organ systems in the abdomen, abdominal pain is a concern of general practitioners/family physicians, surgeons, internists, emergency medicine doctors, pediatricians, gastroenterologists, urologists and gynecologists. Occasionally, patients with rare causes can see a number of specialists before being diagnosed adequately (e.g. chronic functional abdominal pain).

Types and mechanisms

  1. The pain associated with inflammation of the parietal peritoneum is steady and aching, and worsened by changes in the tension of peritoneum caused by pressure or positional change, and is often accompanied by tension of the abdominal muscles contracting to relieve such tension.
  2. The pain associated with obstruction of the hollow viscera is often intermittent or "colicky"
  3. The pain associated with abdominal vascular disturbances (thrombosis or embolism) can be sudden or gradual in onset, and can be severe or mild. Pain associated with the rupture of an abdominal aortic aneurysm may radiate to the back, flank, or genitals.
  4. Pain that is felt in the abdomen may be "referred" from elsewhere (e.g., a disease process in the chest, like a subdiaphragmatic abscess, may cause pain in the abdomen), and abdominal processes can cause radiated pain elsewhere (e.g. gall bladder pain—in cholecystitis or cholelithiasis—is often referred to the shoulder).

Selected causes

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