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

Solid Visceral

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

Mesenteric

• Lymphadenitis (bacterial, viral)
• Epiploic appendagitis

Pelvic

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

Mechanical Intraperitoneal Causes of Acute Abdominal Pain

Hollow Visceral

• Intestinal obstruction
  • Adhesions, hernias, neoplasms, volvulus
  • Intussusception, gallstone ileus, foreign bodies
  • Bezoars, parasites
• Biliary obstruction
  • Calculi, neoplasms, choledochal cyst, hemobilia

Solid Visceral

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

Mesenteric

• Omental torsion

Pelvic

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

Hemoperitoneum

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

Ischemic

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