Abdominal pain causes

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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 causes of abdominal pain vary with the distribution of the pain. The distribution can be determined by various methods, such as into either abdominal quadrants or nine sections.

Causes Based upon Location

Diffuse Abdominal Pain | Intraperitoneal | Extraperitoneal | Epigastric and Upper Quadrant | Right Upper Quadrant | Right Lower Quadrant | Left Upper Quadrant | Left Lower Quadrant | Pelvic/Hypogastric Region

Selected Causes

• Abdominal wall injury/disruption:
  • Abdominal cutaneous nerve entrapment syndrome (ACNES), also known as intercostal neuralgia
  • Diverticulosis (rare)
  • Mesenteric traction
  • Muscle trauma
  • Muscular infection
• Autoimmune:
  • sarcoidosis
  • vasculitis
• Diarrhea
• Digestive:
  • lactose intolerance
  • celiac sprue
• Distention of visceral surfaces such as the hepatic or renal capsule
• Endometriosis
• Functional pain:
  • Irritable bowel syndrome (affecting up to 20% of the population, IBS is the most common cause of recurrent, intermittent abdominal pain)
• Inflammation of bowel wall:
  • Crohn's disease
  • Diverticulitis
  • Gastroenteritis
  • Microscopic colitis
  • Ulcerative colitis

• Mechanical obstruction of hollow viscera such as the small intestine, the appendix associated with appendicitis, the large intestine (e.g. by intussusception), the biliary tree (e.g. by gallstones), or the ureter (e.g. by urinary calculi)
• Meningitis
• Metabolic disturbance:
  • Adrenal insufficiency
  • Black widow spider bite
  • C1-esterase inhibitor deficiency
  • Diabetic ketoacidosis
  • Lead poisoning,
  • Porphyria
  • Uremia
• Neurogenic pain:
  • Herpes zoster
  • Lyme disease (Lyme radiculitis or Bannwarth syndrome)
  • Tabes dorsalis

• Parietal peritoneal inflammation
  • Due to infection: inflamed or suppurative appendix in appendicitis, pelvic inflammatory disease
  • Due to chemical irritation: perforated gastric or peptic ulcer; pancreatitis, Mittelschmerz, ruptured ectopic pregnancy
  • Miscellaneous (Familial Mediterranean fever)
• Pelvic inflammatory disease
• Post-surgical adhesions
• Referred pain from:
  • Genitals (testicular torsion)
  • Coronary occlusion)
  • The spine (radiculitis secondary to arthritis)
  • The thorax (pneumonia

• Reproductive organs (in women):
  • Ectopic pregnancy
  • Mittelschmerz
  • Torsion of the ovary
• Vascular disturbances (leading to ischemia):
  • Embolism
  • Left renal vein entrapment
  • Sickle cell anemia
  • Superior mesenteric artery syndrome (Nutcracker syndrome)
  • Thrombosis
  • Torsional occlusion (volvulus)
  • Vascular rupture

Acute Abdomen

Common causes of acute abdomen include:

• Acute appendicitis
• Acute cholecystitis
• Acute diverticulitis
• Acute intestinal ischemia
• Acute pancreatitis
• Acute peptic ulcer and its complications
• Acute peritonitis
• Acute ureteral colic
• Bowel perforation with free air or bowel contents in the abdominal cavity
• Bowel volvulus
• Diabetic ketoacidosis
• Ectopic pregnancy with tubal rupture

Chronic Functional Abdominal Pain

Common causes of CFAP stem from:

• Abdominal etiologies
• Gynecologic etiologies
  • Dysmenorrhea
  • Endometriosis
  • Müllerian abnormalities
  • Ovarian abnormalities
  • Pelvic inflammatory disease

Causes of Abdominal Pain by Organ System

Cardiovascular	Abdominal aortic aneurysm, Budd-Chiari syndrome.
Chemical / poisoning	Amanita phalloides, arsenic poisoning, Barium nitrate, cresol, fluoride poisoning, grape seed extract, lead poisoning, oleander, parathion, pesticide, pyridine, snakebites, spider bite, tributyl phosphate.
Dermatologic	No underlying causes
Drug Side Effect	Acetylsalicylic acid, aciclovir, aminocaproic acid, auranofin, azithromycin, bezafibrate, caspofungin, cefdinir, cefuroxime, cladribine (patient information), clidinium, clindamycin, clofibrate, contraceptive patch, dactinomycin (patient information), danazol (patient information), daptomycin, diflunisal, donepezil, drotrecogin alfa, dydrogesterone, enoxaparin, erythromycin, ethcathinone, etoposide Phosphate (patient information), flucytosine, fluvastatin, halofantrine, hydroxychloroquine, idarubicin (patient information), isoniazid, itraconazole, loperamide, lopinavir, loprazolam, magnesium citrate, mercaptopurine, methimazole (patient information), methylphenidate, mifepristone, misoprostol, moxifloxacin, muscarine, nafcillin, neuromuscular-blocking drugs, niclosamide, nitazoxanide, octreotide injection (patient information), omeprazole, orlistat (patient information), pegaspargase (patient information), pentavalent antimonial, pentostatin (patient information), perindopril, phenazocine, praziquantel, prazosin and polythiazide (patient information), procainamide (patient information), procarbazine (patient information), propylthiouracil (patient information), roxithromycin, simvastatin, sorafenib (patient information), sucralfate (patient information), sulfasalazine (patient information), thiotepa (patient information), tianeptine, topiramate, topotecan hydrochloride (patient information), trastuzumab (patient information), triclofos, vardenafil, vigabatrin, vinblastine (patient information), voriconazole.
Ear Nose Throat	No underlying causes
Endocrine	No underlying causes
Environmental	No underlying causes
Gastroenterologic	Abdominal cramps, abdominal cutaneous nerve entrapment syndrome, abdominal mass, accessory pancreas, acute pancreatitis, appendicitis, autoimmune hepatitis, autoimmune pancreatitis, bacterial gastroenteritis, bowel obstruction, caecitis, carcinoid syndrome, celiac disease, Charcot's triad, cholangiocarcinoma, cholangitis, cholecystitis, choledochal cysts, chronic pancreatitis, cirrhosis, clostridial necrotizing enteritis, colitis, colonic polyps, colorectal cancer, constipation, Crohn's disease, diverticulitis, duodenitis, dyspepsia, enteritis, epiploic appendagitis, gastric outlet obstruction, gastritis, gastroenteritis, gastrointestinal perforation, gastrointestinal stromal tumor, hemosuccus pancreaticus, ileitis, ileus, intestinal malrotation, intestinal pseudoobstruction, intussusception (medical disorder), irritable bowel syndrome, ischemic colitis, König's syndrome, Krukenberg tumor, malabsorption, Meckel's diverticulum, mesenteric ischemia, ogilvie syndrome, pancreatic cancer, pancreatitis, peptic ulcer, peritonitis, porcelain gallbladder, proctitis, pseudomembranous colitis, pseudomyxoma peritonei, toxic megacolon, ulcerative colitis, volvulus, Whipple's disease.
Genetic	Gilbert's syndrome, marfan syndrome, periodic fever syndrome, pyruvate carboxylase deficiency, slone's disease.
Hematologic	Capillary leak syndrome, cholesterol emboli syndrome, mastocytosis, porphyria.
Iatrogenic	Adjustable gastric band, postcholecystectomy syndrome, short bowel syndrome, transfusion-associated graft versus host disease.
Infectious Disease	African horse sickness, anisakis, ascaris infection, Astroviridae, bacillus cereus, blastocystosis, brachylaima, campylobacteriosis, cat scratch fever, cestoda, clostridium difficile, Colorado tick fever, cryptosporidium parvum, Dengue fever, ebola, entamoeba histolytica, familial mediterranean fever, fasciolopsiasis, fasciolosis, fungemia, fusarium, Giardia lamblia, hantavirus pulmonary syndrome, helicobacter pylori infection, henipavirus, hookworm, hymenolepiasis, isosporiasis, leptospirosis, mycobacterium avium complex, norovirus, opisthorchis infection, paragonimus infection, Q fever, rheumatic fever, Rocky Mountain spotted fever, salmonellosis, scarlet fever, schistosomiasis, scombrotoxic fish poisoning, shigellosis, strongyloidiasis, toxocariasis, trichomoniasis, typhoid fever, Vibrio vulnificus, viral hepatitis , Whipworm infection, yellow fever, yersiniosis.
Musculoskeletal / Ortho	No underlying causes
Neurologic	Autonomic neuropathy.
Nutritional / Metabolic	Diabetic ketoacidosis, food allergy, food intolerance, lactic acidosis, metabolic acidosis, pantothenic acid, Zieve's syndrome.
Obstetric / Gynecologic	Cervical cancer, ectopic pregnancy, endometrial cancer, endometriosis, menstruation, ovarian cancer, ovarian cyst, ovarian hyperstimulation syndrome, ovarian torsion, pelvic inflammatory disease, placental abruption, pregnancy, Salpingitis, uterine fibroids, uterine rupture, uterine sarcoma.
Oncologic	Desmoplastic small round cell tumor, liposarcoma, liver tumor, mesothelioma, Sacrococcygeal teratoma.
Opthalmologic	No underlying causes
Overdose / Toxicity	4-Nitrophenol, cicutoxin, cinchonism, clitocybe dealbata, colchicine, hebeloma crustuliniforme, sorbitol, statins (patient information), tegaserod (patient information), tetrodotoxin, Vitamin A.
Psychiatric	No underlying causes
Pulmonary	Empyema, Pleuritis, Basal pneumonia Pulmonary embolism Pulmonary infarction Tuberculosis.
Renal / Electrolyte	Hydronephrosis, hypercalcemia, hyperkalemia, hypocalcemia, nutcracker syndrome, polycystic kidney disease, pyelonephritis, ureterocele, urinary tract infection.
Rheum / Immune / Allergy	Polyarteritis nodosa, Systemic lupus erythematosus.
Sexual	No underlying causes
Trauma	No underlying causes
Urologic	Prostate cancer, Prostatitis.
Miscellaneous	Alcoholic hepatitis, chronic fatigue syndrome, chronic functional abdominal pain, foreign body, ruptured spleen, side stitch, Situs inversus, Zollinger-Ellison syndrome.

Causes of Abdominal pain in Alphabetical Order

4-Nitrophenol Abdominal aortic aneurysm Abdominal cramps Abdominal cutaneous nerve entrapment syndrome Abdominal mass Accessory pancreas Acetylsalicylic acid Aciclovir Acute pancreatitis Adjustable gastric band African horse sickness Alcoholic hepatitis Amanita phalloides Aminocaproic acid Anisakis Appendicitis Arsenic poisoning Ascaris infection Astroviridae Auranofin Autoimmune hepatitis Autoimmune pancreatitis Autonomic neuropathy Azithromycin Bacillus cereus Bacterial gastroenteritis Barium nitrate Bezafibrate Blastocystosis Bowel obstruction Brachylaima Budd-Chiari syndrome Caecitis Campylobacteriosis Capillary leak syndrome Carcinoid syndrome Caspofungin Cat scratch fever Cefdinir Cefuroxime Celiac disease Cervical cancer Cestoda Charcot's triad Cholangiocarcinoma Cholangitis Cholecystitis Choledochal cysts Cholesterol emboli syndrome Chronic fatigue syndrome Chronic functional abdominal pain Chronic pancreatitis Cicutoxin Cinchonism Cirrhosis Cladribine (patient information) Clidinium Clindamycin Clitocybe dealbata Clofibrate Clostridial necrotizing enteritis Clostridium difficile Colchicine Colitis Colonic polyps Colorado tick fever Colorectal cancer Constipation Contraceptive patch Cresol Crohn's disease Cryptosporidium parvum Dactinomycin (patient information) Danazol (patient information) Daptomycin Dengue fever Depo-Provera Desmoplastic small round cell tumor Diabetic ketoacidosis Diflunisal Diverticulitis Donepezil Drotrecogin alfa Duodenitis Dydrogesterone Dyspepsia Ebola Ectopic pregnancy Endometrial cancer Endometriosis Enoxaparin Entamoeba histolytica Enteritis Epiploic appendagitis Erythromycin Ethcathinone Etoposide phosphate (patient information) Familial Mediterranean fever Fasciolopsiasis Fasciolosis Flucytosine Fluoride poisoning Fluvastatin Food allergy Food intolerance Foreign body Functional bowel disorder Fungemia Fusarium Gallbladder cancer Gastric outlet obstruction Gastritis Gastroenteritis Gastrointestinal perforation Gastrointestinal stromal tumor Giardia lamblia Gilbert's syndrome Grape seed extract Halofantrine Hantavirus pulmonary syndrome Hebeloma crustuliniforme Helicobacter pylori infection Hemosuccus pancreaticus Henipavirus Histrelin injection (patient information) Hookworm Hydronephrosis Hydroxychloroquine Hymenolepiasis Hypercalcemia Hyperkalemia Hypocalcemia Idarubicin (patient information) Ileitis Ileus Implanon Intestinal malrotation Intestinal pseudoobstruction Intussusception (medical disorder) Irritable bowel syndrome Irukandji syndrome Ischemic colitis Isoniazid Isosporiasis Itraconazole König's syndrome Krukenberg tumor Lactic acidosis Lead poisoning

Leptospirosis Liposarcoma Liver tumor Loperamide Lopinavir Loprazolam Magnesium citrate Malabsorption Marfan syndrome Marine toxins Mastocytosis Meckel's diverticulum Menstruation Mercaptopurine Mesenteric ischemia Mesothelioma Metabolic acidosis Metagonimiasis Methimazole (patient information) Methylphenidate Mifepristone Misoprostol Moxifloxacin Muscarine Mushroom poisoning Mycobacterium avium complex Nafcillin Natural childbirth Neuromuscular-blocking drugs Niclosamide Nitazoxanide Norovirus Nutcracker syndrome Octreotide injection (patient information) Ogilvie syndrome Oleander Omeprazole Opisthorchis infection Orlistat (patient information) Ovarian cancer Ovarian cyst Ovarian hyperstimulation syndrome Ovarian torsion Pancreatic cancer Pancreatitis Pantothenic acid Paragonimus infection Parathion Pegaspargase (patient information) Pelvic inflammatory disease Pentavalent antimonial Pentostatin (patient information) Peptic ulcer Perindopril Periodic fever syndrome Peritonitis Pesticide Phenazocine Pink lady (medicine) Placental abruption Polyarteritis nodosa Polycystic kidney disease Porcelain gallbladder Porphyria Postcholecystectomy syndrome Praziquantel Prazosin and polythiazide (patient information) Pregnancy Premature birth Procainamide (patient information) Procarbazine (patient information) Proctitis Propylthiouracil (patient information) Prostate cancer Prostatitis Pseudomembranous colitis Pseudomyxoma peritonei Pyelonephritis Pyridine Pyruvate carboxylase deficiency Q Fever Rheumatic fever Rocky Mountain spotted fever Roxithromycin Ruptured spleen Sacrococcygeal teratoma Salmonellosis Salpingitis Scarlet fever Schistosomiasis Scombrotoxic fish poisoning Shigellosis Short bowel syndrome Side stitch Simvastatin Situs inversus Slone's disease Small intestine cancer Snakebites Soft tissue sarcoma Sorafenib (patient information) Sorbitol Spider bite Splenic infarction Splenomegaly Spontaneous bacterial peritonitis Statins (patient information) Stomach cancer Strongyloidiasis Sucralfate (patient information) Sulfasalazine (patient information) Systemic lupus erythematosus Tegaserod (patient information) Tetrodotoxin Thiotepa (patient information) Tianeptine Topiramate Topotecan hydrochloride (patient information) Toxic megacolon Toxocariasis Transfusion-associated graft versus host disease Trastuzumab (patient information) Tributyl phosphate Trichomoniasis Triclofos Typhoid fever Ulcerative colitis Ureterocele Urinary tract infection Uterine fibroids Uterine rupture Uterine sarcoma Vardenafil Vibrio vulnificus Vigabatrin Vinblastine (patient information) Viral hepatitis Vitamin A Volvulus Voriconazole Whipple's disease Whipworm infection Yellow fever Yersiniosis Zieve's syndrome Zollinger-Ellison syndrome