acute abdominal pain
Introduction
Introduction Acute abdominal pain refers to sudden pain in the abdomen of the patient. It is often caused by diseases of the abdominal or extra-abdominal organs. The former is called visceral abdominal pain, often paroxysmal with nausea, vomiting and sweating. A series of related symptoms, abdominal pain is transmitted by the splanchnic nerve; while the latter abdominal pain is transmitted by the somatic nerves, so it is called somatic abdominal pain, often persistent, and often without nausea and vomiting.
Cause
Cause
Acute abdominal pain refers to sudden pain in the abdomen of the patient. It is often caused by diseases of the abdominal or extra-abdominal organs. The former is called visceral abdominal pain, often paroxysmal with nausea, vomiting and sweating. A series of related symptoms, abdominal pain is transmitted by the splanchnic nerve; while the latter abdominal pain is transmitted by the somatic nerves, so it is called somatic abdominal pain, often persistent, and often without nausea and vomiting.
1. Acute peritoneal inflammation
Most often caused by stomach and intestinal perforation, abdominal pain has the following characteristics:
1, pain positioning is obvious, generally located in the site of inflammation, may involve pain.
2, sustained severe pain.
3. Abdominal pain is often exacerbated by stress, altered body position, coughing or sneezing.
4, tenderness, rebound tenderness and muscle tension.
5. The bowel sounds disappear.
2. Acute inflammation of the abdominal organs
Such as acute gastritis, acute enteritis, acute pancreatitis.
3. Cavity organ obstruction or expansion
Abdominal pain is often paroxysmal and colic, can be very severe, such as intestinal obstruction, biliary ascariasis, urinary tract stone obstruction, gallstone colic.
4. Organs are twisted or broken
Acute twitching of the pedicled organs (ovary, gallbladder, mesentery, omentum, etc.) can cause strong cramps or persistent pain. Acute visceral rupture such as liver rupture, rupture of the spleen, rupture of ectopic pregnancy, acute pain and signs of internal bleeding.
5. Intra-abdominal vascular obstruction
Rarely, abdominal pain is quite intense, mainly in heart disease, hypertension, arteriosclerosis, such as superior mesenteric artery embolism, dissection aortic aneurysm.
6. Poisoning and metabolic disorders
Such as lead poisoning colic, acute hematoporphyria, diabetic ketotoxicosis, often have the following characteristics:
1. Abdominal pain is severe without clear positioning.
2, abdominal pain is severe, but it is significantly contrasted with mild abdominal signs.
3, there are primary clinical manifestations and laboratory examination features.
7. The pain involved in chest disease
Pneumonia, pulmonary infarction, acute myocardial infarction, acute pericarditis, hiatal hernia, etc., pain can be radiated to the abdomen, similar to "acute abdomen."
8. Neurofunctional abdominal pain.
Examine
an examination
Related inspection
Duodenogastric reflux test and imaging fecal occult blood test abdominal wall tension fecal food residue
1. The site of pain:
The site of abdominal pain is often the location of the lesion. Stomach pain is located in the upper middle abdomen. The pain of hepatobiliary disease is located in the right upper abdomen. Acute appendicitis pain is often at the McBurney point. Small intestine colic is located in the umbilical cord. Colonic colic is often located in the lower abdomen. The bladder pain is located in the upper part of the pubis. Acute lower abdominal pain is also seen in acute pelvic inflammatory disease.
2. The nature and extent of pain:
Perforation of peptic ulcer often occurs suddenly, with severe knife cuts and burning like persistent upper abdominal pain. Biliary colic, renal colic, and colic are also very severe, and the patient is often stunned and uneasy. Drilling under the xiphoid is a feature of biliary aphid obstruction. Sustained extensive abdominal pain is seen in acute diffuse peritonitis. The gastrointestinal crisis of the spinal cord is characterized by severe electric shock.
3. Factors that induce exacerbation or relief of pain:
Acute peritonitis abdominal pain is relieved when lying down, and the abdominal wall is pressurized or aggravated when changing position. Patients with lead colic often press. Biliary colic can be induced by a fat meal. Gluttony is the cause of acute gastric dilatation. The role of violence is often the cause of rupture of the liver and spleen. Acute hemorrhagic necrotic enteritis is associated with unclean diet.
Diagnosis
Differential diagnosis
Acute abdominal pain is accompanied by the following symptoms and has implications for diagnosis:
1. With jaundice, can be seen in acute liver, biliary tract disease, pancreatic disease, acute hemolysis, lobar pneumonia.
2. With chills, high fever, can be seen in acute suppurative biliary tract inflammation, abdominal organ abscess, lobar pneumonia, suppurative pericarditis.
3. Hematuria, often a urinary system disease.
4. With shock, common in acute intra-abdominal hemorrhage, acute obstructive suppurative biliary tract inflammation, strangulated intestinal obstruction, acute perforation of peptic ulcer, acute pancreatitis, acute torsion of abdominal organs, acute myocardial infarction, shock pneumonia.
