Some Important Causes Of Abdominal Pain

1. Parietal peritoneal inflammation

a. Bacterial contamination, e.g., perforated appendix, pelvic Inflammatory disease

b. Chemical irritation, e.g., perforated ulcer, pancreatitis, mittelschmerz

2. Mechanical obstruction of hollow viscera

a. Obstruction of the small or large intestine

b. Obstruction of the biliary tree

c. Obstruction of the ureter

3. Vascular disturbances

a. Embolism or thrombosis

b. Vascular rupture

c. Pressure or torsional occlusion

d. Sickle cell anemia

4. Abdominal wall

a. Distortion or traction of mesentery

b. Trauma or infection of muscles

5. Distention of visceral surfaces, e.g., hepatic or renal capsules

PAIN REFERRED FROM EXTRAABDOMINAL SOURCE

1. Thorax, e.g., pneumonia, referred pain from coronary occlusion

2. Spine, e.g., radiculitis from arthritis

3. Genitalia, e.g., torsion of the testicle

METABOLIC CAUSES

1. Exogenous

a. Black widow spider bite

b. Lead poisoning and others

2. Endogenous

a. Uremia

b. Diabetic ketoacidosis

c. Porphyria

d. Allergic factors (C'1 esterase inhibitor deficiency)

NEUROGENIC CAUSES

1. Organic

a. Tabes dorsalis

b. Herpes zoster

c. Causalgia and others

2. Functional

Some Mechanisms Of Pain Originating In The Abdomen

• Inflammation of the Parietal Peritoneum: steady and aching, Stomach acid, feces, pancreatic juice, bile, blood and urine, bacteria.
• Accentuated by pressure. Tonic reflex spasm over area.

• Obstruction Of Hollow Viscera: intermittent or colicky. Poorly localized.
• Vascular Disturbances: severe or diffuse pain. Absence of tenderness and rigidity.
• Abdominal Wall: constant and aching. Accentuated by movement or pressure.

Category: Medicine Notes