left lower abdominal pain
Introduction
Introduction Colitis abdominal pain is usually pain or cramping, often located in the left lower abdomen or lower abdomen. Other manifestations include loss of appetite, bloating, nausea, vomiting, and large liver. The left lower abdomen may have tenderness and sometimes reach the colon of the sputum. Left lower abdominal pain is generally a problem of the sigmoid colon, left ovary and fallopian tubes, left ureter. The incidence of blood relatives in this disease is high. According to European and American literature statistics, about 15-30% of the immediate blood relatives of patients with ulcerative colitis are affected. In addition, twin studies have shown that monozygotes are more likely to develop than diploids, suggesting that the occurrence of this disease may be related to genetic factors.
Cause
Cause
Left lower abdominal pain is generally a problem of the sigmoid colon, left ovary and fallopian tubes, left ureter. Common in colitis.
The cause of colitis:
1. Genetics: The incidence of bloody families in this disease is high. According to the statistics of European and American literature, about 15-30% of the direct blood relatives of patients with ulcerative colitis are affected. In addition, twin studies have shown that monozygotes are more likely to develop than diploids, suggesting that the occurrence of this disease may be related to genetic factors.
2. Infection: The pathological changes and clinical manifestations of this disease are similar to some colonic infectious diseases (such as bacterial dysentery), so some people believe that infection is the cause of this disease. Among the many factors such as bacteria, fungi and viruses, current research indicates that the virus is more likely.
3. Autoimmune response: Most scholars believe that this disease is an autoimmune disease. Because the disease is complicated by autoimmune diseases (such as autoimmune hemolytic anemia), adrenal cortical hormone can relieve the disease, anti-colon epithelial cell antibodies can be found in the serum of some patients, so the occurrence of this disease may be considered Related to autoimmune reactions. In addition, some patients may be infected with intestinal bacteria, and may immunoreact with colonic epithelial cell antigen, damage the colonic mucosa, and the patient's lymphocytes have cytotoxic effects on fetal colonic epithelial cells, suggesting that the occurrence of colitis may also be associated with cells. Immune abnormalities are related.
4. Neuropsychiatric factors: Some people think that mental factors play a certain role in the pathogenesis. Patients have certain personality traits. They have poor psychological endurance and adaptability to major events in life. They are a kind of psychosomatic diseases. Psychosomatic diseases emphasize psychological factors. It plays an important role in the occurrence or course of the disease. Some people have classified 7 diseases as psychosomatic diseases, namely: asthma, rheumatoid arthritis, ulcerative colitis, essential hypertension, neurodermatitis, hyperthyroidism and ten Duodenal ulcer. More diseases may be classified as psychosomatic diseases.
Examine
an examination
Related inspection
Closed-pore inner muscle test abdominal CT closed-cell internal muscle test fiber colonoscopy
First, physical examination
Taking a medical history gives us a first impression and revelation, and also guides us to a concept of the nature of the disease.
Second, laboratory inspection
Laboratory examinations must be summarized and analyzed based on objective data learned from medical history and physical examination, from which several diagnostic possibilities may be proposed, and further consideration should be given to those examinations to confirm the diagnosis. Such as blood, urine routine, biochemical examination, liver function, hepatitis B and so on.
Third, other inspections
Gastroscopic examination can detect inflammation, ulcers, tumors and vascular lesions of the esophagus, stomach and duodenum; colonoscopy can detect lesions of the colon and rectum.
X-ray digestive tract barium meal examination and barium enema are also important examination methods for digestive tract diseases. In particular, it can understand the function of gastrointestinal tract emptying, wall lesions and stenosis, but it can not be displayed for small lesions. Patients who cannot undergo endoscopy can choose X-ray examination, which complements each other.
B-ultrasound is very accurate for the examination of organs such as hepatobiliary, pancreas, spleen and kidney. It is the first choice for these organs.
Diagnosis
Differential diagnosis
Right lower abdominal pain: Abdominal pain is one of the most common clinical symptoms. But because abdominal pain is mostly sporadic, it is often easy for patients to take it lightly. The approximate division of the location of the abdominal organs. Upper right: liver, gallbladder, biliary tract, pancreas, duodenum, right kidney, right segment of the large intestine. Top left: stomach, spleen, pancreas, left kidney, left colon. Bottom right: cecum, appendix, right ovary and fallopian tube, right ureter.
Bottom left: sigmoid colon, left ovary and fallopian tube, left ureter. Right lower abdominal pain is a disease of the cecum, appendix, right ovary and fallopian tube, right ureter. Painful mass can be seen in the lower left abdomen: can be seen in ulcerative colitis, rectum, sigmoid cancer. Rectal, sigmoid schistosomiasis granuloma, left ovarian cyst and so on. Right lower quadrant tenderness: one of the symptoms of acute appendicitis. Acute appendicitis is the first place in various surgical acute diseases. Symptoms: Metastatic right lower abdominal pain is a typical clinical manifestation of acute appendicitis. Because of the visceral transposition of the cecum and appendix in the left lower abdomen, metastatic left lower abdominal pain should also consider the possibility of left appendicitis.
The location of the initial pain and the time required for the transfer process vary from person to person, but it should be noted that about 1/3 of the patients start with right lower abdominal pain, especially in the acute attack of chronic appendicitis, so no metastatic right lower abdominal pain can not be completely excluded. The presence of acute appendicitis must be combined with other symptoms and signs. Lower abdominal pain is a more common type of gynecological disease. Lower abdominal bulge is mainly related to pelvic congestion. Many of them can be classified as medically known as pelvic congestion syndrome. Patients with acute lower abdominal pain should be carefully and carefully asked about the history, including history of menopause, history of vaginal bleeding, location of abdominal pain, nature, radiation pain and anemia. Combined with internal diagnosis and B-ultrasound, pregnancy test, posterior malleolar puncture, lower abdominal X-ray film and other auxiliary diagnosis. Laparoscopic or laparotomy should be performed if necessary.
Abdominal dull pain and soreness: It is one of the clinical manifestations of abdominal wall hernia. Interparietal hernia is a special form of inguinal hernia. It is characterized by the fact that the abdominal organs do not descend through the abdominal tube. It is through the intra-abdominal ring into the abdominal wall between the various levels. Some patients had a history of inguinal hernia. After the incarceration, the patient or the doctor gave a manual reduction treatment. After the reduction, the block disappeared, but the symptoms of abdominal pain still existed and progressively worsened. Physical examination showed signs of intestinal obstruction, the position of the testicles on the oblique side increased, and the mass of the lower abdomen touched the mass and tenderness.
