What are Some Causes of Abdominal Pain?

Abdominal pain is a common clinical symptom, and it is also the reason that prompts patients to see a doctor. Abdominal pain is usually caused by some strong irritation or damage to the abdominal tissues or organs. It can also be caused by chest diseases and systemic diseases. In addition, abdominal pain is a subjective sensation. The nature and intensity of abdominal pain are affected not only by the condition of the lesion and the degree of stimulation, but also by neurological and psychological factors. That is, patients have different sensitivities to pain stimuli. Abdominal pain caused by stimuli of the same lesion in different patients or in different periods of the same patient differs in nature, intensity and duration.

Basic Information

Visiting department: General Surgery
Common locations: abdomen

Common causes: Acute inflammation of abdominal organs, torsion of abdominal organs, etc.
Common symptoms: pain

Causes of abdominal pain

Acute abdominal pain

(1) Diseases of abdominal organs

1) Acute inflammation of abdominal organs: acute gastroenteritis, acute corrosive gastritis, acute cholecystitis, acute pancreatitis, acute appendicitis, acute cholangitis, etc.

2) Perforation or rupture of abdominal organs: perforation of gastric and duodenal ulcers, perforation of typhoid fever, rupture of liver, rupture of spleen, rupture of kidney, rupture of ectopic pregnancy, rupture of ovary, etc.

3) Obstruction or expansion of abdominal organs: gastric mucosal prolapse, acute intestinal obstruction, inguinal hernia intussusception, intussusception, biliary ascariasis, cholelithiasis, kidney and ureteral stones, etc.

4) Abdominal organ torsion: acute gastric torsion, ovarian cyst pedicle torsion, omental torsion, intestinal torsion, etc.

5) Intra-abdominal vascular occlusion: acute obstruction of mesenteric artery, acute portal vein thrombosis, dissection of abdominal aortic aneurysm, etc.

(2) Abdominal wall diseases: abdominal wall contusion, abdominal wall abscess, and abdominal wall shingles.

(3) Thoracic diseases: acute myocardial infarction, acute pericarditis, angina pneumonia, and pulmonary infarction.

(4) Systemic diseases and others: rheumatic fever, uremia, acute lead poisoning, hematoporphyria, abdominal allergic purpura, abdominal epilepsy, etc.

2. Causes of chronic abdominal pain

Diseases of abdominal organs:

(1) Chronic inflammation: reflux esophagitis, chronic gastritis, chronic cholecystitis, chronic pancreatitis, tuberculous peritonitis, inflammatory bowel disease, etc.

(2) Gastrointestinal diseases: stomach, duodenal ulcer and gastrinoma.

(3) Torsion or obstruction of abdominal organs: chronic gastrointestinal torsion, intestinal adhesions, omental adhesion syndrome, etc.

(4) Increased capsule tension: liver congestion, hepatitis, liver abscess, liver cancer, splenomegaly, etc.

(5) Gastrointestinal motor dysfunction: gastroparesis, functional dyspepsia, hepatic flexure, and splenic flexure syndrome.

Clinical manifestations of abdominal pain

1. The nature and extent of abdominal pain

The nature of abdominal pain is related to the nature of the organ and the lesion. For example, colic often indicates cavity obstruction; pain is often caused by increased visceral envelope tension, mesangial tension, or inflation of the cavity organs. The degree of pain is sometimes consistent with the severity of the lesion, but due to individual differences, sometimes the degree of pain does not reflect the extent of the lesion.

2. Abdominal pain

The location of abdominal pain is often related to the segmental distribution of the spinal cord. Usually, the pain site is the lesion site, but some lesions cause pain to radiate to the fixed area. For example, acute cholecystitis can radiate to the right scapula and back, and pain caused by appendicitis can be transferred from the umbilical cord to the right lower abdomen.

3. Accompanying symptoms

Abdominal pain accompanied by fever indicates inflammation, connective tissue disease, malignancy, etc .; vomiting indicates esophageal, gastric or biliary disease; vomiting indicates gastrointestinal obstruction; diarrhea indicates intestinal inflammation, malabsorption, pancreatic disease; with shock, at the same time Anemia indicates rupture of abdominal organs (such as liver or spleen rupture or ectopic pregnancy rupture), myocardial infarction, pneumonia may also have abdominal pain with shock, should be particularly vigilant; with urgency, frequent urination, dysuria, hematuria, etc., indicating possible urinary Department of infection or stones; with gastrointestinal bleeding, such as tar-like stools or vomiting blood suggestive of peptic ulcer or gastritis; if blood or dark red bloody stool, often suggest ulcerative colitis, colon cancer, intestinal tuberculosis and so on.

Abdominal pain examination

Perform necessary tests or special inspections. Such as three routine, blood, urinary amylase, liver and kidney function, abdominal or lower abdomen B-ultrasound (including urinary system and pelvic cavity), plain radiography, chest X-ray, if necessary, CT or MRI examination; elderly people should also make Examinations such as electrocardiograms for a clear and timely diagnosis.

Differential diagnosis of abdominal pain

According to the characteristics of abdominal pain and associated symptoms, such as:

1. Sudden acute pain is more common in gastric perforation, intestinal perforation, biliary ascariasis, and urinary stones.

2. Abdominal pain with fever, mostly dysentery, cholecystitis, cholelithiasis, acute appendicitis, acute pancreatitis and so on.

3. Patients with abdominal pain and pale face, cold sweat, blood pressure and other symptoms, most of them are organ perforation, visceral bleeding, ectopic pregnancy rupture and other critical diseases.

4. Those with prominent abdominal pain and obvious vomiting are found in cholera, cholera-like disease, acute enteritis and other diseases.

5. Abdominal pain with hematuria, mostly urinary diseases, such as acute cystitis, urinary stones, kidney cancer and so on.

6. Patients with abdominal pain and blood in the stool should consider intestinal cancer, intestinal tuberculosis, Crohn and other diseases.

7. Abdominal pain in dysmenorrhea and ectopic pregnancy is closely related to menstruation.

8. Intestinal obstruction. At the same time as abdominal pain, bowel type or bowel peristaltic waves can be seen in the abdomen, or masses are touched.

9. The abdominal wall is like a plate, which can be peritonitis, gastric perforation and other diseases.

10. When abdominal pain is associated with night sweats, hot flashes and other symptoms, mesenteric and peritoneal tuberculosis can be seen.

11. Women who have obvious lower abdominal pain during menstruation are dysmenorrhea.

Abdominal pain treatment

1. Patients with acute abdominal pain should not be given a strong analgesic, or narcotic analgesics such as morphine or pethidine (dolidine), before they are diagnosed, so as not to conceal the condition or delay the diagnosis. Only after the diagnosis is initially established can analgesics or antispasmodics be applied to alleviate the patient's pain.

2. It is clear that abdominal pain is caused by gastrointestinal perforation. Fasting, supplementation of energy and electrolytes, and timely application of broad-spectrum antibiotics should lay a good foundation for timely surgical treatment.

3. If acute abdominal pain is caused by rupture of the liver or spleen (such as ruptured nodules of liver cancer or rupture of the liver and spleen due to abdominal trauma, etc.), a large amount of bloody fluid can often be drawn out of the abdominal cavity, and the patient is often accompanied by hemorrhagic shock. In addition to the application of analgesics, anti-shock treatment such as blood volume should be actively added to create good conditions for surgical treatment.

4. Abdominal pain is caused by acute intestinal obstruction, intestinal ischemia or intestinal necrosis, or acute pancreatitis. Fasting should be performed and gastrointestinal decompression should be performed on the upper nasogastric tube before corresponding treatment measures should be adopted.

5. It is clear that abdominal pain is caused by cholelithiasis or urinary stones, and antispasmodics can be given. Common bile duct stones can be treated with pethidine (duolidine).

6. Acute abdominal pain in women of childbearing age, especially in cases of severe pain in the middle and lower abdomen, should be asked about the history of menopause, and timely pelvic B-mode ultrasound examination to determine the presence of ectopic pregnancy, ovarian cyst and torsion.

7. In patients with acute abdominal pain, although the diagnosis cannot be clearly confirmed through multiple examinations, if the vital signs are stable, while actively supporting the treatment, the changes in the condition can still be closely observed. If the symptoms worsen during the observation, when the patient is suspected of having visceral hemorrhage, intestinal necrosis, cavity organ perforation or diffuse peritonitis, a timely laparotomy should be performed to save the patient's life.