Intraperitoneal causes of abdominal pain

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Intraperitoneal Causes of Abdominal Pain

Inflammatory Intraperitoneal Causes of Acute Abdominal Pain

Peritoneal

• Bacterial peritonitis
  • Perforated hollow viscus
  • Primary peritonitis (Pneumococcal, streptococcal, tuberculous; spontaneous bacterial peritonitis)
• Chemical and nonbacterial peritonitis
  • Perforated peptic ulcer/biliary tree, pancreatitis, ruptured ovarian cyst, mittelschmerz

Hollow Visceral

• Appendicitis
• Cholecystitis
• Colitis (bacterial, amebic)
• Diverticulitis
• Duodenitis
• Gastritis
• Gastroenteritis
• Inflammatory bowel disease
• Meckel diverticulitis
• Peptic ulcer

Solid Visceral

• Abscess (pancreatic, hepatic, splenic, etc.)
• Hepatitis
• Pancreatitis

Mesenteric

• Epiploic appendagitis
• Lymphadenitis (bacterial, viral)

Pelvic

• Endometritis
• Pelvic inflammatory disease (salpingitis)
• Tubo-ovarian abscess

Mechanical Intraperitoneal Causes of Acute Abdominal Pain

Hollow Visceral

• Intestinal obstruction
  • Adhesions
  • Bezoars
  • Foreign Bodies
  • Gallstone Ileus
  • Hernias
  • Intussusception
  • Neoplasms
  • Parasites
  • Volvulus

• Biliary obstruction
  • Calculi
  • Choledochal cyst
  • Hemobilia
  • Neoplasms

Solid Visceral

• Acute splenomegaly
• Acute hepatomegaly (congestive heart failure, Budd-Chiari syndrome)

Mesenteric

• Omental torsion

Pelvic

• Ectopic pregnancy
• Ovarian cyst
• Torsion or degeneration of fibroid

Hemoperitoneum

• Ruptured aortic or visceral aneurysm
• Ruptured ectopic pregnancy
• Ruptured graafian follicle
• Ruptured hepatic neoplasm
• Ruptured mesentery
• Ruptured uterus
• Spontaneous splenic rupture

Ischemic

• Hepatic infarction (toxemia, purpura)
• Mesenteric thrombosis
• Omental ischemia
• Splenic infarction
• Strangulated hernia