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Abdominal Pain Causes - Doctors Lounge(TM)The diagnosis of . The mildest of abdominal pains may herald an. Any patient with abdominal pain of recent. Common causes of abdominal pain. Abdominal wall pain. Pain arising from the abdominal wall is usually constant and aching. Movement. prolonged standing, and pressure accentuate the discomfort and muscle spasm. This kind of pain may arise from a disease of the muscle (myositis. Abdominal wall pain often presents with a dermatomic pattern. Characteristically, it. Coughing, sneezing, or lifting heavy. Visceral pain. The best approach for visceral pain is according to location of. Location is most easily categorized on the basis of embryologic. Pain located between the xiphoid process and the umbilicus originates in the. Pain in the periumbilical region arises from viscera of the midgut (eg, small. ![]() Pain between the umbilicus and the symphysis pubis emanates from hindgut organs. The foregut. Pain in the epigastric area. The epigastrium is an area of the central abdomen lying just below the sternum. Common. causes are dyspepsia, peritonitis, pancreatitis, GI obstruction, gall bladder. Other causes include. Pain in the right upper quadrant (hypochondrium)Causes of right upper quadrant pain include liver diseases, gall bladder. Chron's disease, atypical appendicitis or even constipation). ![]() Other causes include referred pain from. Many metabolic diseases can give the same picture including, diabetic. Addisionian crisis, adrenal tuberculosis and metastatic carcinoma. The spleen may be enlarged or may be the seat of an infarction. ![]() ![]() The midgut. Pain in the periumbulical region. Causes of. periumbulical pain include intestinal obstruction, mesenteric occlusion or. The hindgut. Right lower quadrant pain. Pain in the right lower quadrant may be diffuse, as in early appendicitis, or crampy and nonradiating, as in. Colon obstruction secondary to colon cancer, diverticulitis. Yersinia. enterocolitica and Campylobacter sp., may mimic appendicitis and cause right. The classic presentation of Crohn's disease. Low- grade fever and. High fever indicates a possible. Hematochezia occurs in a minority of. In women right lower quadrant pain could be a manifestation of pelvic inflammatory disease. Cancer of the cecum, ileal. TB, and ameboma should be excluded. Left lower quadrant pain. Diverticulitis, inflammatory bowel disease, pelvic inflammatory disease, a. Pain in the hypogastrium and pelvis. Common. causes of pain in this area include rectal disease (rectal cancer, proctitis). Pain in the costovertebral angle. This is. usually attributed to renal causes (kidney stones, pyelonephritis. Biliary pain typically presents with constant, steady pain. Severe intensity and a . Rapidly progressive (over 1- 2 hours) pain is seen typically in pancreatitis, cholecystitis, diverticulitis, bowel obstruction, renal or biliary. Gradual (over several hours) pain that progresses more slowly is more typical. Pain occurring following the onset of vomiting often. Persistence of pain for over 6 hours after acute onset has a. Aggravating or alleviating factors. Pain. relieved by antacids suggests peptic ulcer disease or esophagitis. Pain worsened. by movement suggests peritonitis, whereas constant movement by the patient in an. Patients with partial relief by leaning forward, and. Pain relieved by defecation may suggest a colonic source. Patients with postprandial pain, food avoidance, weight. Crohn's. disease). Pain that occurs at approximately monthly intervals. Mittelschmerz. Physical examination. Vital signs. Tachycardia & hypotension: Vital signs may show tachycardia and hypotension indicative of intraabdominal hemorrhage or septic shock. Fever: The fever of appendicitis, diverticulitis, and cholecystitis is. Inspection. Abdominal distention: Abdominal distention may suggest bowel obstruction or the presence of ascites. Scaphoid abdomen: A scaphoid, tense abdomen. Auscultation Auscultation of the abdomen should be performed before palpation or. High- pitched hyperactive bowel sounds may also be seen in. Succussion splash: The presence of a succussion splash suggests gastric outlet. Percussion. Tenderness on percussion: Percussion of the abdomen allows assessment of the presence of. Pain produced by light tapping indicates inflammation of the. This pain may also be elicited by asking the patient to. Tympany: A. distended abdomen with tympany upon percussion suggests a bowel obstruction. Palpation. Tightening (rigidity) of the abdominal wall musculature occurs. Involuntary guarding indicates peritoneal inflammation. Tenderness over Mc. Burney's point should be considered very. Cholecystitis and salpingitis are often well localized as well. Patients with an unimpressive abdominal examination and. Murphy's sign refers to pain produced by deep inspiration. Pain produced by lightly punching the costovertebral angle. Carnett's test refers to the response of pain when the patient. Worsening of pain during this maneuver suggests an abdominal wall. The iliopsoas sign refers to pain produced by passive extension. The obturator sign refers to pain produced by rotation of the. A rectal examination can reveal focal tenderness from an. A pelvic examination is mandatory in female patients to look. The inguinal and femoral canals, umbilicus, and surgical scars. Once a cause is suspected the appropriate diagnostic. Diagnosis. If the picture is obscure then the following important points and. Ruptured ectopic pregnancy in. Dissecting aortic aneurysm: Absence of tenderness and rigidity in the presence of continuous. This pain may persist over a period of. Peritoneal pain: Rigidity, rebound tenderness, fever and leucocytosis. Metabolic causes. Familial mediterranean fever. Diabetic ketoacidosis. Irritable bowel syndrome: Is the commonest cause of abdominal pain and should always be kept. If the cause of abdominal pain is still unclear, investigations. Lab work. X- rays (supine, erect, lateral view) Ultrasound. CAT scan. Laparoscopy. Operation vs. Often, the diagnosis can be made through. Chronic epigastric pain can be caused by peptic ulcer, chronic pancreatitis. GERD, dyspepsia, gall bladder disease. Chronic lower abdominal pain can be caused by irritable bowel syndrome. Right lower quadrant fullness and pain or. Crohn's disease. Less common causes include causes in the abdominal wall, fibromyalgia, hernia. Addison's disease) and psychological disorders. The evaluation of chronic abdominal pain in a patient younger than 5. This my include a CBC. TSH and electrolyte levels, and examination with flexible sigmoidoscopy. Those with alarm symptoms or age above 5. Are you a Doctor, Pharmacist, PA or a Nurse? Join the Doctors Lounge online medical community. 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