Extraperitoneal causes of acute abdominal pain

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

Extraperitoneal Causes of Acute Abdominal Pain

Genitourinary

• Pyelonephritis
• Perinephric abscess
• Renal infarct
• Nephrolithiasis
• Ureteral obstruction (urolithiasis, tumor)
• Acute cystitis
• Prostatitis
• Seminal vesiculitis
• Orchitis/Epididymitis
• Testicular torsion
• Dysmenorrhea
• Threatened abortion

Pulmonary

• Pneumonia
• Empyema
• Pulmonary embolism (infarction)
• Pneumothorax

Cardiac

• Myocardial ischemia/infarction
• Acute rheumatic fever
• Acute pericarditis

Metabolic

• Acute intermittent porphyria
• Familial Mediterranean fever
• Hypolipoproteinemia
• Hemochromatosis
• Hereditary angioneurotic edema
• Uremia

Endocrine

• Diabetic ketoacidosis
• Hyperparathyroidism (hypercalcemia)
• Acute adrenal insufficiency (Addisonian crisis)
• Hyperthyroidism or hypothyroidism

Musculoskeletal

• Rectus sheath hematoma
• Arthritis/diskitis of thoracolumbar spine

Neurogenic

• Herpes zoster
• Tabes dorsalis
• Nerve root compression
• Spinal cord tumors
• Osteomyelitis of the spine
• Abdominal epilepsy
• Abdominal migraine
• Multiple sclerosis

Inflammatory

• Henoch-Schönlein purpura
• Systemic lupus erythematosus
• Polyarteritis nodosa
• Dermatomyositis
• Scleroderma

Infectious

• Bacterial
• Parasitic (malaria)
• Viral (measles, mumps, infectious mononucleosis)
• Rickettsial (Rocky Mountain spotted fever)

Hematologic

• Acute leukemia
• Acute hemolytic states
• Coagulopathies
• Pernicious anemia
• Other dyscrasias

Vascular

• Vasculitis
• Periarteritis

Toxins

• Bacterial toxins (tetanus, staphylococcus)
• Insect venom (black widow spider)
• Animal venom
• Heavy metals (lead, arsenic, mercury)
• Poisonous mushrooms
• Drugs
• Narcotics withdrawal

Retroperitoneal

• Retroperitoneal hemorrhage (spontaneous adrenal hemorrhage)
• Psoas abscess

Psychogenic

• Hypochondriasis
• Somatization disorders

Factitious

• Munchausen syndrome
• Malingering