lower abdominal tenderness
Introduction
Introduction Suspected abdominal injury must first check the abdomen, there is no tenderness, rebound tenderness. Abdominal pain refers to the symptoms of pain that occur below the stomach sputum and above the pubic hair. The occurrence of abdominal pain is mainly caused by exogenous sensation, unhealthy diet, emotional disorder and yang deficiency, which cause qi stagnation, collateral stagnation or meridian dystrophy, and poor blood circulation. Clinical analysis should be combined with the location of abdominal pain, the nature of pain, urgency, duration, and associated symptoms.
Cause
Cause
The site of tenderness is often the lesion:
1 right upper abdomen tenderness, seen in liver, gallbladder, colonic hepatic flexion, ascending colon and kidney lesions.
2 upper abdominal tenderness, found in the stomach, duodenum, liver, gallbladder, pancreas and transverse colon and other diseases.
3 left upper abdomen tenderness, see ten spleen, pancreatic tail, left kidney, colon spleen and descending colon lesions.
4 right waist tenderness, mostly caused by kidney and ascending colon lesions.
5 fat tenderness, seen in small bowel lesions, such as enteritis, intestinal parasitic diseases.
6 left lumbar tenderness, seen in the left kidney and descending colon lesions.
7 has lower abdominal tenderness, more common in appendicitis, can also be caused by ileocecal or right fallopian tube disease.
8 lower abdominal tenderness, seen in bladder and female genital lesions.
9 left abdomen tenderness, seen in the sigmoid colon and left fallopian tube lesions.
In addition, abdominal extra-abdominal lesions such as pneumonia, pleural lesions, myocardial infarction, etc. can also produce abdominal tenderness, should be noted.
Examine
an examination
Related inspection
Fiber endoscopy
1. The tenderness caused by abdominal wall lesions is obvious when grasping the abdominal wall or lifting the shoulder on the back.
2. The tenderness caused by intra-abdominal lesions can be caused by inflammation of the organs, congestion, tumors, rupture, torsion, and stimulation of the peritoneum.
3. Common tender points in the abdomen:
1 The gallbladder point tenderness at the junction of the right rectus abdominis and the costal margin marks gallbladder lesions.
2 McBurney point tenderness at the junction of the umbilical cord and the right upper anterior superior iliac spine line at the junction of the anterior superior iliac crest suggests a appendix lesion.
The 3rd rib point (pre-kidney point) is located at the front end of the 10th rib and is the position of the renal pelvis.
4 The upper ureteral point is on the outer edge of the rectus abdominis on the umbilical level.
5 The ureteral point is on the outer edge of the rectus abdominis on the horizontal line of the anterior superior iliac spine, which is equivalent to the second stenosis of the ureter.
The rib ridge point is located at the apex of the 12th rib and the transverse process of the spine, also called the rib angle, which is the position of the kidney.
7 waist points.
Diagnosis
Differential diagnosis
Need to distinguish from the following symptoms:
Abdominal dull pain and soreness: lower abdominal pain and soreness are one of the clinical manifestations of abdominal wall hernia. Interparietal hernia is a special form of inguinal hernia. It is characterized by: abdominal organs Not through the ventral tube, but through the intra-abdominal ring into the abdominal wall between the various levels.
Lower abdomen mass: The lower abdomen mass refers to a mass in the lower abdomen. The touch has a hard feeling. It may be benign or malignant, mostly gynecological disease symptoms or intestinal and peritoneal diseases.
The left lower abdomen can touch the tender mass: the painful mass in the left lower abdomen can be seen in ulcerative colitis, rectum, and sigmoid cancer. Rectal, sigmoid schistosomiasis granuloma, left ovarian cyst and so on.
