right abdominal pain
Introduction
Introduction The right upper abdomen is also called the pain in the liver area. The liver is located in the right abdomen of the human body. Therefore, the right abdomen of the human body is painful, that is, the liver area is painful, but the liver itself does not cause pain, mainly because the liver capsule outside the liver is pulled. The pain, the area of pain is largely related to the liver. In addition, this may be caused by excessive exercise or overwork. Under such conditions, the liver may be under strong pressure, causing discomfort in the right abdomen.
Cause
Cause
Pathologically, the possible cause of right abdomen pain is mainly due to liver damage or peripheral organs being squeezed to the liver, causing the outer capsule of the liver to contract or expand, causing pain, right abdomen pain. Different, there are stinging, cramping, pain, etc., the cause of the different forms of pain is not the same, you need to use the hospital's specific report to confirm the treatment.
1. The liver develops lesions. This condition mainly occurs in liver inflammation caused by hepatitis B, which causes degeneration and necrosis of liver cells and pulls the liver capsule to produce nerve pain.
2, strenuous exercise or overwork. This is normal and can be recovered with a little rest. This is also common in everyday life.
3. Other diseases. Other diseases such as appendicitis can also cause pain in the right abdomen.
Examine
an examination
Related inspection
Abdominal MRI examination abdominal abdomen plain film endoscopy
Laboratory inspection
1, blood, urine, feces routine, ketone body and serum amylase is the most commonly used laboratory tests.
The total number of white blood cells and the increase of neutrophils suggest that inflammatory lesions are almost all items that need to be examined in patients with abdominal pain. A large number of red blood cells in the urine suggest urinary stones, tumors or trauma. Proteinuria and white blood cells suggest a urinary system infection. Pus and blood will prompt intestinal infection, bloody stools suggest strangulated intestinal obstruction, mesenteric thromboembolism, hemorrhagic enteritis and so on.
Increased serum amylase is suggested to be pancreatitis, which is the most commonly used blood biochemical test for differential diagnosis of abdominal pain. The determination of blood sugar and blood ketone can be used for abdominal pain caused by diabetic ketosis. Increased serum bilirubin suggests biliary fatigue. Examination of liver and kidney function and electrolytes is also helpful in judging the condition.
2. Routine and biochemical examination of abdominal puncture fluid.
Abdominal puncture must be performed when the diagnosis of abdominal pain is unclear and abdominal fluid is found. The liquid obtained by puncture should be sent for routine and biochemical examination, and if necessary, bacterial culture is required. However, the visual observation of the puncture fluid has been helpful in the diagnosis of intra-abdominal hemorrhage and infection.
Auxiliary inspection
1, X-ray inspection
Abdominal X-ray examination is the most widely used in the diagnosis of abdominal pain. The free gas, gastrointestinal perforation found in the armpit is almost certain. Intestinal gas expansion, most fluids in the intestine can diagnose intestinal obstruction. Calcification of the sputum can prompt ureteral stones. Lumbar muscle shadows appear blurred or disappear, suggesting peritoneal inflammation or bleeding. X-ray barium meal imaging, or barium enema examination can find gastroduodenal ulcers, tumors and so on. Only in case of suspected intestinal obstruction, taboo meal should be contraindicated. Gallbladder, cholangiography, endoscopic retrograde cholangiopancreatography and percutaneous cholangiography are helpful for the differential diagnosis of biliary and pancreatic diseases.
When the diagnosis is difficult, suspected and chest and abdomen have lesions, it is feasible to see the chest and abdomen, the purpose is to observe the presence or absence of lesions in the chest, free air under the armpits, changes in diaphragmatic movement, presence or absence of intestinal gas and fluid level, etc. Regular filming. When suspected sigmoid torsion or low intussusception, barium enema examination is feasible. It is not advisable to have a barium meal examination for patients suspected of having intestinal obstruction, internal hemorrhoids or perforation.
2, B-ultrasound
Mainly used to check biliary and urinary calculi, bile duct dilatation, pancreas and hepatosplenomegaly. It also has a good diagnostic value for a small amount of effusion, intra-abdominal cysts and inflammatory masses in the abdominal cavity.
3, endoscopy
Endoscopy has become an important means of finding the cause of abdominal pain. Retrograde cholangiopancreatography, cystoscopy, and laparoscopy can also be performed if the patient's condition permits. It can be used for the differential diagnosis of gastrointestinal diseases, which is often required in patients with chronic abdominal pain.
4, CT, magnetic resonance and radionuclide scanning
For intra-abdominal and retroperitoneal lesions, such as liver, spleen, pancreatic lesions and some intra-abdominal masses and abdominal abscesses, effusion, gas accumulation, etc. have a good diagnostic value, should be selected according to the condition.
5, ECG check
For older patients, an electrocardiogram should be performed to understand the myocardial blood supply and to exclude myocardial infarction and angina pectoris.
Diagnosis
Differential diagnosis
Differential diagnosis:
The liver itself is not sensitive to pain. The main cause of pain in the liver area is the pain caused by stimulation of the intrahepatic bile duct and the pain caused by the pulling of the liver cell membrane. Pain in the liver area refers to a painful feeling in the area under the right rib or under the xiphoid process. The pain is intermittent or persistent. Dull pain or tingling, the patient may feel discomfort in the right upper quadrant for a period of time before the pain. Pain can be relieved when it is light or heavy.
Right lower abdominal pain is a disease of the cecum, appendix, right ovary and fallopian tube, right ureter.
Left upper abdominal pain may be a problem in the stomach, spleen, pancreas, left kidney, and left colon.
The right upper quadrant pain was paroxysmal cramps and radiated to the right shoulder, mostly cholecystitis and cholelithiasis.
