Abdominal pain causes: Difference between revisions
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Revision as of 19:17, 19 January 2015
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Resident Survival Guide |
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Abdominal pain Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Abdominal pain On the Web |
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American Roentgen Ray Society Images of Abdominal pain |
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
Causes Based upon Location
Diffuse | Left Upper Quadrant | Left Flank | Left Lower Quadrant | Epigastric Region | Umbilical Region | Pelvic Region | Right Upper Quadrant | Right Flank | Right Lower Quadrant
Life Threatening Causes
Life-threatening causes include conditions that may result in death or permanent disability within the next 24 hours if left untreated.
Common Causes
- Injury to the Abdominal wall
- Abdominal cutaneous nerve entrapment syndrome
- Mesenteric traction syndrome
- Muscle trauma
- Muscular infection
- Autoimmune:
- Diarrhea
- Digestive:
- 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
Causes by Organ System
Causes in Alphabetical Order
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