[3] About 15% of people have a more serious underlying condition such as appendicitis, leaking or ruptured abdominal aortic aneurysm, diverticulitis, or ectopic pregnancy.
The most common cause of persistent dull or aching abdominal pain is edema or distention of the wall of a hollow viscus.
[4] The most frequent reasons for abdominal pain are gastroenteritis (13%), irritable bowel syndrome (8%), urinary tract problems (5%), inflammation of the stomach (5%) and constipation (5%).
About 10% of cases have a more serious cause including gallbladder (gallstones or biliary dyskinesia) or pancreas problems (4%), diverticulitis (3%), appendicitis (2%) and cancer (1%).
[2] More common in those who are older, ischemic colitis,[5] mesenteric ischemia, and abdominal aortic aneurysms are other serious causes.
[6] Acute abdomen is a condition where there is a sudden onset of severe abdominal pain requiring immediate recognition and management of the underlying cause.
[14] Each subsection of the gut has an associated visceral afferent nerve that transmits sensory information from the viscera to the spinal cord.
Such at home strategies may reduce the need to seek professional assistance via prevention of future abdominal pain.
[22] Treatment for abdominal pain includes analgesia, such as non-opioid (ketorolac) and opioid medications (morphine, fentanyl).
[23] Surgical management for causes of abdominal pain includes but is not limited to cholecystectomy, appendectomy, and exploratory laparotomy.
Periumbilical pain, migrates to RLQ Abdominal CT IV fluids as needed General surgery consultation, possible appendectomy Antibiotics Pain control Imaging (RUQ ultrasound) Labs (leukocytosis, transamintis, hyperbilirubinemia) IV fluids as needed General surgery consultation, possible cholecystectomy Antibiotics Pain, nausea control Labs (elevated lipase) Imaging (abdominal CT, ultrasound) IV fluids as needed Pain, nausea control Possibly consultation of general surgery or interventional radiology Imaging (abdominal X-ray, abdominal CT) IV fluids as needed Nasogastric tube placement General surgery consultation Pain control Labs (complete blood count, coagulation profile, transaminases, stool guaiac) Blood transfusion as needed Medications: proton pump inhibitor, octreotide Stable patient: observation Unstable patient: consultation (general surgery, gastroenterology, interventional radiology) Labs (complete blood count, coagulation profile, transaminases, stool guaiac) Blood transfusion as needed Medications: proton pump inhibitor Stable patient: observation Unstable patient: consultation (general surgery, gastroenterology, interventional radiology) Imaging (abdominal X-ray or CT showing free air) Labs (complete blood count) General surgery consultation Antibiotics Cecal volvulus: Abdominal pain (acute onset), nausea, vomiting Imaging (abdominal X-ray or CT) Cecal: General surgery consultation (right hemicolectomy) If ruptured ectopic pregnancy, the patient may present with peritoneal irritation and hypovolemic shock Labs: complete blood count, urine pregnancy test followed with quantitative blood beta-hCG Imaging: transvaginal ultrasound If patient is stable: continue diagnostic workup, establish OBGYN follow-up Imaging: Ultrasound, CT angiography, MRA/magnetic resonance angiography If patient is stable: admit for observation Imaging: Chest X-ray (showing widened mediastinum), CT angiography, MRA, transthoracic echocardiogram/TTE, transesophageal echocardiogram/TEE Blood transfusion as needed (obtain type and cross) Medications: reduce blood pressure (sodium nitroprusside plus beta blocker or calcium channel blocker) Surgery consultation Imaging: FAST examination, CT of abdomen and pelvis Diagnostic peritoneal aspiration and lavage If patient is unstable: general or trauma surgery consultation with subsequent exploratory laparotomy Imaging: FAST examination, CT of abdomen and pelvis Diagnostic peritoneal aspiration and lavage If patient is unstable: general or trauma surgery consultation with subsequent exploratory laparotomy and possible splenectomy If patient is stable: medical management, consultation of interventional radiology for possible arterial embolization One well-known aspect of primary health care is its low prevalence of potentially dangerous abdominal pain causes.
[26] In general, it is discovered that 20% to 25% of patients with abdominal pain have a serious condition that necessitates admission to an acute care hospital.
[2] Rates of emergency department (ED) visits in the United States for abdominal pain increased 18% from 2006 through to 2011.
[31] Additionally, they have changed the strength and integrity of their skin and mucous membranes, which are physical barriers to infection.
[33] Unique clinical challenges arise when pregnant women experience abdominal pain.
For instance, concerns about fetal safety during pregnancy are raised by invasive exams and radiologic testing.
Fourth, while receiving therapy during pregnancy, the mother's and the fetus' interests need to be taken into account.