Abdominal Pain

Question 1

Types of pain

Answer 1

1)Visceral pain: internal organs or Bvs: distension of hollow organ, or excessive small muscle contraction. through Symp splanchnic nerves
Dull ache can’t be localised
2)Somatic pain: muscles bones and soft tissue
;peritoneum, abdominal wall
by the intercostal nerve
sharp pain can be localised to the site of inflammation
(as in appendicitis)

Question 2

Site? Generalised? Localised? Where ?

Answer 2

1)epigastric area> pain from foregut:
esophagus ,stomach ,dudonem ,liver ,pancreas
2) periumbilical area> pain from midgut:
dudonem,jejunum,ilium,ascending colon,rt 2/3 transverse colon
3)suprapubic area> pain from hindgut:
ft1/3 transverse colon,descending colon,rectum,anal canal,sigmoid

Question 3

Is it radiating? Or shifting

Answer 3

1-back» pancreatic pain penetrating PU
2-groin»renal pain
3-shoulder»biliary, GB disease
4-neck»GERD
5-umbilical to RLQ»appendicitis

Question 4

Causes of abdominal ?!

Answer 4

1-RUQ(liver,GB,Biliary tract):Hepatitis ,Cholecystitis ,Biliary colic ,Cholangitis ,Perforator DU
2-Epigastric(pancreas Esophagus Stomach Duodenum): Pancreatitis GERD Gastritis PU
3-LUQ(Spleen Pancreas): Pancreatitis ,PU
4-Rt Lumber(Kidney Ureters): Pyelonephritis ,Kidney stone
5-Umbilical(Stomach T. Colon S. Colon): PU
Early Appendicitis IBS, IBD Umbilical hernia
6-Lt lumber(Kidney Ureters): Pyelonephritis ,Kidney stone
7-RLQ(Appendix Cecum Ovary): Appendicitis, IBD, PID,Ovarian torsion ,Ectopic Pregnancy
8-Suprapubic(Bladder Uterus): UTI Testicular torsion PID
9-LLQ(D. Colon): IBD Diverticulosis

Question 5

Abdominal- pain (SOCRATES)?

Answer 5

• S ite
• O nset: acute, gradual, chronic
• C haracter; colicky, dull,stabbing,burning,steady
• R adiation (if the symptom is pain or discomfort)
• A lleviating factors , associated symptoms
• T iming and duration, change in pattern of pain
• E xacerbating factors
• S everity.; how to asses from 1-10

Question 6

Pattern of pain ; (Pancreatic pain)?

Answer 6

steady epigastric pain
partly relieved by sitting up and leaning forwards.

Question 7

Aggravating and relieving factors;
Pain due to peptic ulceration?

Answer 7

occur after meals (when acid
increases) may be relived by antacids.

Question 8

Non alimentary causes of abdominal pain ??

Answer 8

• Myocardial infarction: epigastric pain
• Diabetic ketoacidosis
• Salpingitis or tubal pregnancy
• Torsion of the ovary or testis :
lower abdominal pain nausea and vomiting