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

Causes Based upon Location

Life Threatening Causes

Conditions that may cause death or permanent disability within the next 24 hours

Common Causes

Injury to the Abdominal wall
- Abdominal cutaneous nerve entrapment syndrome
- Diverticulosis (rare)
- Mesenteric traction syndrome
- 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

Causes 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, clidinium, clindamycin, clofibrate, contraceptive patch, dactinomycin, danazol, daptomycin, diflunisal, donepezil, drotrecogin alfa, dydrogesterone, enoxaparin, erythromycin, ethcathinone, etoposide phosphate, flucytosine, fluvastatin, halofantrine, hydroxychloroquine, idarubicin, isoniazid, itraconazole, loperamide, lopinavir, loprazolam, magnesium citrate, mercaptopurine, methimazole, methylphenidate, mifepristone, misoprostol, moxifloxacin, muscarine, nafcillin, neuromuscular-blocking drugs, niclosamide, nitazoxanide, octreotide injection, omeprazole, orlistat, pegaspargase, pentavalent antimonial, pentostatin, perindopril, phenazocine, praziquantel, prazosin and polythiazide, procainamide, procarbazine, propylthiouracil, roxithromycin, simvastatin, sorafenib, sucralfate, sulfasalazine, thiotepa, tianeptine, topiramate, topotecan, trastuzumab, triclofos, vardenafil, vigabatrin, vinblastine, 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, tegaserod, 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 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

References

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