Understanding Abdominal Pain Flashcards
What are the organs of the foregut?
Oesophagus, stomach, liver, gallbladder, pancreas to proximal duodenum.
What are the organs of the midgut?
Distal duodenum to the proximal 2/3 of transverse colon.
What are the organs of the hind gut?
Distal 1/3 of transverse colon to the rectum.
What is visceral pain?
Deep organ pain which is non-specific and poorly localised, and unaffected by movement. Pain follows embryological distribution and usually in the midline.
What is parietal pain?
Sensor nerve fibres transmit signals from the parietal peritoneum that follows the dermatomal level, and worse on movement, because it is localised to the structure. Typically sharp pain.
What does epigastric pain indicate?
Foregut issue.
What does periumbilical pain indicate?
Midgut issue.
What does lower pain indicate?
Hindgut issue.
Epigastric pain radiating to the right upper quadrant?
Cholecystitis: inflammation of the gall bladder.
Epigastric pain radiating to the back?
Pancreatitis.
Periumbilical pain radiating to the lower right quadrant?
Appendicitis.
Periumbilical pain radiating to the lower region?
Meckel’s diverticulitis, a congenital abnormality where a remnant of the vitelline duct is not obliterated. The vitelline duct is important for connection between yolk sac and midgut.
Hypogastric pain radiating to the left iliac fossa?
Diverticulitis.
Epigastric pain radiating to the lower right iliac fossa?
Duodenal ulcer.
What are causes of acute abdominal pain?
Obstruction
Ischaemia/Infarct
Torsion of organs
Rupturing
-> These are emergencies that require urgent surgical intervention.
What does subacute/ chronic abdominal pain indicate?
Crohn’s disease
Chronic pancreatitis
What is colicky pain?
Gripping pain that comes and goes in waves, which can be exacerbated during defaecation.
What is non-colicky pain?
Persistent pain that is only relieved by analgesics, usually due to inflammation.
What is abdominal pain associated with in the GI tract?
Vomiting, weight changes, fever, bowel changes
What is abdominal pain in the gynaecological system?
Vaginal bleeding or dysmenorrhoea(painfu menstruation)
What is abdominal pai associated with in urological system?
Fever, UTI, bleeding and frequency of urination.
What is abdominal pain associated with in vascular system?
Dizziness, sweating and palpitations.
What are extraperitoneal causes of abdominal pain?
Abdominal wall bruising or haematoma.
Referred pain from Testicular torsion or herpes dermatome
What are the medical conditions that cause abdominal pain?
Electrolyte disturbances
Sickle cell crisis
Leukaemia
Hyperparathyoridism
What is bowel obstruction?
Divided into open-ended or close-ended bowel obstruction. It is commonly caused by adhesions due to surgery, hernia or tumour. Hypovolaemic shock is common because of loss of fluid from intravascular space into colon.
It causes colicky abdominal pain, constipation, vomiting and distention.
Causes of bowel obstruction in the foregut?
Pyloric stenosis
Strictures that are malignant or bending
Foreign body
Food bolus
Causes of bowel obstruction in the midgut?
IBS
Causes of bowel obstruction in the hindgut?
Strictures
Volvulus: loop of intestine twists around itself
