Abdominal pain

• Types:
1. Visceral
2. Parietal
3. Referred
4. psychogenic
 Acute abdomen
• Causes:
1. inflammatory;
 Appendicitis
 Diverticulitis
 Pancreatitis
 Pyelonephritis
 Cholecystitis
 PID
 Intra abdominal absccess
2. Perforation/rupture;
 Peptic ulcer
 Aortic anaeurysm
 Ovarian cyst
 Diverticular disease
3. obstruction;
 Intestinal obstruction
 Biliary colic
 Ureteric colic
4. others(rare), extraintestinal
Management of acute abdominal pain:
• General approach: perforations- closed,
inflammation- antibiotics and/ resection,
relieve obstructions. Need for surgery
depends on organ and on a number of factors,
of which the presence or absence of
peritonitis(guarding and rebound tenderness
with rigidity) is most important.
 Chronic or recurrent abdominal pain
• Extraintestinal causes:
1. Retroperitoneal; aortic aneurysm, lymphadenopathy,
malignancy, abscess.
2. Psychogenic; depression, hypochondriasis, anxiety,
somatisation.
3. Locomotor; vertebral compression or fracture, abdominal
muscle strain.
4. Metabolic or endocrine; DM, hypercalcemia, acute
intermittent porphyria.
5. Drugs/toxains; glucocorticoids, lead, azathioprine, alcohol.
6. Neurological; spinal cord lesions, radiculopathy, tabes dorsalis.
Constant abdominal pain