General Abdominal pain

• Abdominal pain arises from the abdominopelvic viscera; the parietal peritoneum; or the capsules of the liver, kidney, or spleen
• Pain may also be referred to the abdomen, sharp, well-localized, referred pain is felt in skin or deeper tissues and may coexist with skin hyperesthesia and muscle hyperalgesia
• Abdominal pain usually results from a GI disorder, but it can be caused by a reproductive, genitourinary (GU), musculoskeletal, or vascular disorder; drug use; or ingestion of toxins. At times, such pain signals life-threatening complications
• Visceral pain develops slowly into a deep

Abdominal pain History and Physical Examination

• If  no life-threatening signs or symptoms,. Ask him if he has had this type of pain before.  describe the pain — dull, sharp, stabbing, or burning.
• Ask the patient is experiencing  anything relieves the pain or makes it worse. Ask  the pain is constant or intermittent and when the pain began.
• Constant, steady abdominal pain suggests organ perforation, ischemia, or inflammation or blood in the peritoneal cavity. Intermittent, cramping abdominal pain suggests that the patient may have obstruction of a hollow organ.

Abdominal pain Medical Cause(s)

• Duodenal ulcer. Localized abdominal pain—described as steady, gnawing, burning, aching, or hunger-like—may occur high in the midepigastrium, slightly off center, usually on the right
• Gastric ulcer. Diffuse, gnawing, burning pain in the left upper quadrant or epigastric area commonly occurs 1 to 2 hours after meals and may be relieved by ingestion of food or antacids
• Gastritis. With acute gastritis, the patient experiences a rapid onset of abdominal pain
• Irritable bowel syndrome. Lower abdominal cramping or pain is aggravated by ingestion
• Renal calculi. Depending on the location of calculi, severe abdominal or back pain may occur
• Ulcerative colitis. Ulcerative colitis may begin with vague abdominal discomfort that leads to cramping lower abdominal pain
• • Abdominal aortic aneurysm (dissecting).
• Abdominal trauma. Generalized or localized abdominal pain occurs with ecchymoses on the abdomen, abdominal tenderness, vomiting and, with hemorrhage into the peritoneal cavity, abdominal rigidity.
• Abdominal pain usually occurs late in abdominal cancer
• Adrenal crisis. Severe abdominal pain appears early, along with nausea, vomiting, dehydration, profound weakness, anorexia, and fever
• Appendicitis. With appendicitis, a life-threatening disorder, pain initially occurs in the epigastric or umbilical region.
• Cholecystitis. Severe pain in the right upper quadrant
• Cirrhosis. Dull abdominal aching occurs early and is usually accompanied by anorexia, indigestion, nausea, vomiting, constipation, or diarrhea
• Intestinal obstruction. Short episodes of intense, colicky, cramping pain alternate with pain-free intervals in an intestinal obstruction, a life-threatening disorder
• Ovarian cyst. Torsion or hemorrhage causes pain and tenderness in the right or left lower quadrant
• Pancreatitis. Life-threatening acute pancreatitis produces fulminating, continuous upper abdominal pain
• Perforated ulcer. With perforated ulcer, a life-threatening disorder, sudden, severe

EMERGENCY INTERVENTIONS Abdominal pain

• If the patient is experiencing sudden and severe abdominal pain, quickly take his vital signs and palpate pulses below the waist. Be alert for signs of hypovolemic shock, such as tachycardia and hypotension.
• surgery may be required if the patient also has mottled skin below the waist and a pulsating epigastric mass or rebound tenderness and rigidity.

Special Considerations

• Help the patient find a comfortable position to ease his distress. He should lie in a supine position, with his head flat on the table, arms at his sides, and knees slightly flexed to relax the abdominal muscles.