17 hours ago · Many medical conditions cause acute abdominal pain, including diabetic ketoacidosis, hypercalcemia, Addison’s disease, and sickle cell crisis. Other less common metabolic causes of acute abdominal pain include uremia, lead poisoning, methanol intoxication, hereditary angioedema, and porphyria. >> Go To The Portal
Evaluation of the emergency department patient with acute abdominal pain is sometimes difficult. Various factors can obscure the presentation, delaying or preventing the correct diagnosis, with subsequent adverse patient outcomes.
Most commonly, abdominal wall pain is related to cutaneous nerve root irritation or myofascial irritation. The pain can also result from structural conditions, such as localized endometriosis or rectus sheath hematoma, or from incisional or other abdominal wall hernias.
Your patient complains of severe right lower quadrant abdominal pain. To assess the patient for peritoneal inflammation, the examiner should: Your patient is lying supine and you ask him to raise his leg while you place resistance against the thigh.
The emergency physician should not hesitate to administer adequate analgesic medication to the patient with acute abdominal pain. When studied, the administration of narcotic analgesics does not obscure the diagnosis or interfere with the treatment of the patient.
Intra-abdominal trauma occurs from blunt forces in about 90% of the cases, most commonly from motor vehicle collisions, auto-pedestrian accidents, falls, sports, bike, and child abuse.
The liver is the most commonly injured organ in blunt abdominal trauma and the second most commonly injured organ in penetrating abdominal trauma [3-6]. The liver is a highly vascular organ located in the right upper quadrant (figure 1) of the abdomen and is susceptible to injury from traumatic mechanisms.
Hemoperitoneum, sometimes also called intra-abdominal hemorrhage or intraperitoneal hemorrhage, is a type of internal bleeding in which blood gathers in your peritoneal cavity. This is the space between your organs and the inner lining of your abdominal wall.
Sometimes, a penetrating injury involves both the chest and the upper part of the abdomen. For example a downward stab wound to the lower chest may go through the diaphragm into the stomach, spleen, or liver. Blunt or penetrating injuries may cut or rupture abdominal organs and/or blood vessels.
These could be symptoms of internal bleeding: dizziness. severe weakness....Internal bleeding in your chest or abdomenabdominal pain.shortness of breath.chest pain.dizziness, especially when standing.bruising around your navel or on the sides of your abdomen.nausea.vomiting.blood in urine.More items...
The abdominal cavity is highly distensible and may easily hold greater than five liters of blood, or more than the entire circulating blood volume for an average-sized individual.
There are multiple causes of intra-abdominal hemorrhage. Some of the possible causes are trauma, ruptures of diseased blood vessels or organs, tumors, aneurysms, pancreatitis, ectopic pregnancy, and complications of surgical procedures. For example, liver cancers can bleed into the intra-abdominal cavity.
Abdominal wall hematoma usually results from bleeding inside the muscle layers of the abdominal wall, most commonly the vascular rectus muscle. A known category of this hematoma is rectus sheath hematoma.
There are three main types of bleeding: arterial, venous, and capillary bleeding.
The area of the body that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs.
Blunt abdominal injuries, such as from a fall or a blow to the stomach, can cause severe bruising of the abdominal wall and bleeding from or rupture of the internal organs. These types of injuries are often caused by falls from a significant height.
Muscle guarding, back and flank pain, nausea, vomiting, and even shock are possible with significant trauma to the kidneys. With enough force transferred to the abdominal area, intestinal damage and even bowel perforation can occur.
Hindgut structures such as the bladder, and distal two-thirds of the colon, as well as pelvic genitourinary organs usually cause pain in the suprapubic region. Pain is usually reported in the back for retroperitoneal structures such as the aorta and kidneys.5,6. Character .
Location . Embryology determines where a patient will “feel” visceral pain, which is generally perceived in the midline because afferent impulses from visceral organs are poorly localized. Visceral nociceptors can be stimulated by distention, stretch, vigorous contraction, and ischemia.
Although labeled “colic,” gallbladder pain is generally not paroxysmal, and it almost never lasts less than 1 hour, with an average of 5–16 hours’ duration, and ranging up to 24 hours.13Small bowel obstruction typically progresses from an intermittent (“colicky”) pain to more constant pain when distention occurs.
Clinicians must consider multiple diagnoses, especially those life-threatening conditions that require timely intervention to limit morbidity and mortality.
Somatic pain is transmitted via the spinal nerves from the parietal peritoneum or mesodermal structures of the abdominal wall. Noxious stimuli to the parietal peritoneum may be inflammatory or chemical in nature (eg, blood, infected peritoneal fluid, and gastric contents).5,7. Onset .
The emergency physician should not hesitate to administer adequate analgesic medication to the patient with acute abdominal pain. When studied, the administration of narcotic analgesics does not obscure the diagnosis or interfere with the treatment of the patient.
Vomiting may occur in almost any abdominal disease. Pain generally precedes vomiting in surgical conditions, with the important exception of esophageal rupture from forceful emesis.10,17It is usually present in small bowel obstruction, unless the obstruction is partial or the patient is presenting early in the course.