Abdominal Pain

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Abdominal pain is discomfort felt anywhere between the chest and groin that can occur because of tissue injury, which could be due to mechanical, inflammatory, and ischemic mechanisms.

Mechanical mechanisms of tissue injury include processes that can cut, tear, or crush abdominal contents, like penetrating injuries seen with knife wounds or blunt injuries that occur during a car crash. Next, inflammatory mechanisms involve swelling, stretching, and distention. This can occur due to infectious processes like appendicitis, diverticulitis, or gastroenteritis. Lastly, ischemic mechanisms can be caused by any condition that obstructs blood flow to abdominal contents, like with mesenteric artery occlusion, which is when a blood clot blocks the artery that supplies oxygenated blood to the intestines.

Abdominal pain can be acute, meaning it develops quickly and resolves over hours to days; or chronic, meaning it can come and go over months or even years. Pain can also be visceral, parietal, or referred.

Visceral pain is typically dull, crampy, or burning in nature and difficult to localize. It can be felt with conditions like appendicitis. Parietal pain tends to be sharp and easy to localize, like with the right upper quadrant pain felt in acute cholecystitis. Referred pain can be dull or sharp, difficult or easy to localize, but is typically noted outside the abdominal region, like when biliary tract disease causes pain in the right shoulder.

Other clinical manifestations that accompany acute abdominal pain may include fever, an elevated white blood cell count, nausea, and vomiting, as well as changes in bowel patterns, like constipation, diarrhea, or the presence of blood or mucus in stool.


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