The correct interpretation of acute abdominal pain is one of the most challenging demands made of any physician. Sometimes proper therapy requires urgent action. A great deal of experience and judgment is needed to elucidate the cause.
A number of mechanisms can produce abdominal pain. Inflammation of the lining of the abdomen (peritoneum) can produce pain of steady, aching character. This pain is usually located directly over the inflamed area and the area will also be quite tender. Release of a small amount of stomach acid will cause much more pain than even contaminated intestinal contents will when
the appendix ruptures.
Another type of pain occurs in the distention or obstruction of hollow organs. This is usually intermittent or cramping in nature. Colic in the abdomen can be produced from obstruction of bile duct, the gallbladder, the ureters, or the intestines. Since all of these may cause vomiting, the location of the pain and other related symptoms must be considered in arriving at a rapid diagnosis. Finally, it is important to consider the blood vessels in the abdomen as causes of potential pain. An out pouching of the aorta (aneurysm) may produce pain, developing slowly, increasing gradually, or in a sudden rupture, may become quite catastrophic. Abdominal angina occurs when the vascular supply to the intestines becomes clogged with cholesterol deposits and this pain, similar to the angina pectoris of the heart, occurs following a heavy meal.
Referred pain from the chest, the spine, or the pelvic organs, may also make diagnosis difficult. Compression or irritation of nerve roots in the spine is usually intensified by coughing, sneezing, or straining. Pressure on the genital organs will usually be very painful and show the origin immediately of this referred pain. Respiratory origin is usually indicated by obvious interference with breathing.
It is important to become acquainted with the clinical pictures of these various abdominal problems. Knowledge of anatomy of abdominal organs, as well as their function is essential in understanding abdominal pain. Some types can be treated safely at home. In these cases, moist heat and temporary abstinence from food is often helpful. There are conditions requiring surgical
intervention. Basically keeping in mind these possibilities will help an individual to seek a physician promptly at the appropriate time while avoiding unnecessary dependence on drugs or expensive diagnostic testing in the more self-limited and trivial conditions.
A number of mechanisms can produce abdominal pain. Inflammation of the lining of the abdomen (peritoneum) can produce pain of steady, aching character. This pain is usually located directly over the inflamed area and the area will also be quite tender. Release of a small amount of stomach acid will cause much more pain than even contaminated intestinal contents will when
the appendix ruptures.
Another type of pain occurs in the distention or obstruction of hollow organs. This is usually intermittent or cramping in nature. Colic in the abdomen can be produced from obstruction of bile duct, the gallbladder, the ureters, or the intestines. Since all of these may cause vomiting, the location of the pain and other related symptoms must be considered in arriving at a rapid diagnosis. Finally, it is important to consider the blood vessels in the abdomen as causes of potential pain. An out pouching of the aorta (aneurysm) may produce pain, developing slowly, increasing gradually, or in a sudden rupture, may become quite catastrophic. Abdominal angina occurs when the vascular supply to the intestines becomes clogged with cholesterol deposits and this pain, similar to the angina pectoris of the heart, occurs following a heavy meal.
Referred pain from the chest, the spine, or the pelvic organs, may also make diagnosis difficult. Compression or irritation of nerve roots in the spine is usually intensified by coughing, sneezing, or straining. Pressure on the genital organs will usually be very painful and show the origin immediately of this referred pain. Respiratory origin is usually indicated by obvious interference with breathing.
It is important to become acquainted with the clinical pictures of these various abdominal problems. Knowledge of anatomy of abdominal organs, as well as their function is essential in understanding abdominal pain. Some types can be treated safely at home. In these cases, moist heat and temporary abstinence from food is often helpful. There are conditions requiring surgical
intervention. Basically keeping in mind these possibilities will help an individual to seek a physician promptly at the appropriate time while avoiding unnecessary dependence on drugs or expensive diagnostic testing in the more self-limited and trivial conditions.
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