Abdominal pain pathophysiology

Abdominal pain Microchapters
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Causes Diffuse Abdominal Pain Left Upper Quadrant Left Flank Left Lower Quadrant Epigastric Quadrant Umbilical Region Pelvic Region Right Upper Quadrant Right Flank Right Lower Quadrant Intraperitoneal Extraperitoneal
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

• The pain associated with the abdomen of inflammation of the parietal peritoneum (the part of the peritoneum lining the abdominal wall) is steady and aching, and worsened by changes in the tension of peritoneum caused by pressure or positional change. It is often accompanied by tension of the abdominal muscles contracting to relieve such tension.
• The pain associated with obstruction of a hollow viscus (as opposed to peritoneal and solid organ pain) is often intermittent or "colicky", coinciding with the peristaltic waves of the organ. Such cramps are exactly what is experienced with early acute appendicitis and gastroenteritis and are somewhat relieved by writhing and massage.
• Pain that is felt in the abdomen may be "referred" from elsewhere (e.g., a disease process in the chest may cause pain in the abdomen), and abdominal processes can cause radiated pain elsewhere (e.g., gall bladder pain—in cholecystitis or cholelithiasis—is often referred to the shoulder).

• The pain associated with abdominal vascular disturbances (thrombosis or embolism) can be sudden or gradual in onset, and can be severe or mild. Pain associated with the rupture of an abdominal aortic aneurysm may radiate to the back, flank, or genitals.