Chapter 13 Abdominal Pain

1 AETIOLOGY
1.1 PAIN ORIGINATING FROM THE ABDOMEN
I. Inflammation of the parietal peritoneum
a. Bacterial peritoneal inflammation
i. Perforated appendix or viscus
ii. Pelvic inflammatory disease
b. Chemical irritation
i. Perforated ulcer
ii. Pancreatitis
iii. Mittelschmerz
II. Obstruction of hollow viscera
a. Obstruction in small or large intestine
b. Obstruction of the biliary tree
c. Obstruction of the ureter
III. Vascular disturbances
a. Embolism or thrombosis
b. Vascular rupture
c. Pressure or torsional occlusion
d. Sickle cell anaemia
IV. Abdominal wall
a. Distortion or traction of mesentery
b. Trauma or infection of muscles
V. Distention of visceral surfaces
a. Hepatic or renal capsules
VI. Inflammation of viscus
a. Appendicitis
b. Typhoid fever
c. Typhlitis
1.2 REFERRED PAIN
I. Cardiothoracic
a. Acute myocardial infarction
b. Myocarditis, endocarditis, pericarditis
c. Congestive heart failure
d. Pneumonia
e. Pulmonary embolus
f. Pleurodynia
g. Pneumothorax
h. Empyema
i. Eosophageal diseas, spasm, rupture, inflammation
II. Genitalia
a. Torsion of the testis
1.3 METABOLIC ABDOMINAL CRISES
I. Diabetes
II. Uremia
Chapter 13 Abdominal Pain
III. Hyperlipidemia
IV. Hyperparathyroidism
V. Acute adrenal insufficiency
VI. Famililal Mediterranean fever
VII. Porphyria
VIII. C1 esterase inhibitor deficiency
1.4 NEUROGENIC
I. Herpes zoster
II. Tabes dorsalis
III. Causalgia
IV. Radiculitis from infection or arthritis
V. Spinal cord or nerve root compression
VI. Functional disorders
VII. Psychiatric disorders
2 DIFFERENTIAL DIAGNOSIS BY LOCATION
2.1 RUQ
I. Cholecystitis