abdominal pain presented by: jesse ellis. definition abdominal pain is pain that you feel anywhere...

Abdominal PainAbdominal Pain

Presented by:Presented by:

Jesse EllisJesse Ellis

DefinitionDefinition

Abdominal pain is pain that you feel Abdominal pain is pain that you feel anywhere between your chest and anywhere between your chest and groin. groin.

Alternative names Alternative names include:include:

Stomach pain Stomach pain

Belly acheBelly ache

Abdominal crampsAbdominal cramps

CharacteristicsCharacteristics Abdominal pain can be sharp, dull, stabbing, cramp-like, knifelike, Abdominal pain can be sharp, dull, stabbing, cramp-like, knifelike,

twisting, or piercing. Many other types of pain are possible.twisting, or piercing. Many other types of pain are possible.

Abdominal pain can be brief, lasting for a few minutes, or it may Abdominal pain can be brief, lasting for a few minutes, or it may persist for several hours and longer. Sometimes abdominal pain persist for several hours and longer. Sometimes abdominal pain comes on strongly for a while and then lessens in intensity for a comes on strongly for a while and then lessens in intensity for a while.while.

Sometimes abdominal pain can hurt so much that the patient may Sometimes abdominal pain can hurt so much that the patient may throw up, with no respite in the pain. Other times, vomiting eases throw up, with no respite in the pain. Other times, vomiting eases the pain.the pain.

Abdominal pain can make the patient want to stay in one place Abdominal pain can make the patient want to stay in one place and not move a muscle. Or the pain can make them so restless and not move a muscle. Or the pain can make them so restless they want to pace around trying to find "just the right position." they want to pace around trying to find "just the right position."

Source: Abdominal Pain in AdultsSource: Abdominal Pain in Adults

CausesCauses Excessive GasExcessive Gas Lactose IntoleranceLactose Intolerance IBSIBS Indigestion/HeartburnIndigestion/Heartburn Gastroesophageal Reflux Gastroesophageal Reflux

(GERD)(GERD) CholecystitisCholecystitis AppendicitisAppendicitis Bowel ObstructionBowel Obstruction Food AllergyFood Allergy Food PoisoningFood Poisoning HerniaHernia Viral GastroenteritisViral Gastroenteritis

Kidney StonesKidney Stones UTIUTI PancreatitisPancreatitis IntussusceptionIntussusception Dissecting Aortic Dissecting Aortic

AneurysmAneurysm Parasite Infection (Giardia)Parasite Infection (Giardia) Sickle Cell CrisisSickle Cell Crisis Chron’s DiseaseChron’s Disease Ulcerative ColitisUlcerative Colitis EndometriosisEndometriosis Uterine Fibroids & cystsUterine Fibroids & cysts Polycystic Kidney DiseasePolycystic Kidney Disease

The The Fantastic 4Fantastic 4

Right Upper Quadrant PainRight Upper Quadrant PainDiagnosisDiagnosis

Cholecystitis Hepatitis (all forms) Liver Cancer Chlamydia Cirrhosis

Source: Healthline.comSource: Healthline.com

CholecystitisCholecystitis

Inflammation of the gallbladder wall.Inflammation of the gallbladder wall. Symptoms:Symptoms:

Pain Pain Nausea Nausea Chronic pain Chronic pain Feels hot to touch Feels hot to touch


HepatitisHepatitis

Hepatitis AHepatitis A Symptoms:Symptoms:

Loss of Loss of appetite appetite

Body ache Body ache Pain Pain HeadacheHeadache

Hepatitis BHepatitis B Symptoms:Symptoms:

Loss of appetite Loss of appetite Pain Pain Abdominal pain Abdominal pain AscitesAscites


Hepatitis continuedHepatitis continued

Hepatitis CHepatitis C Symptoms:Symptoms:

Vomiting Vomiting Joint pain Joint pain Itching Itching Body ache Body ache


Hepatitis D Hepatitis D aka Delta Agentaka Delta Agent Symptoms:Symptoms:

Loss of Loss of appetite appetite

Body ache Body ache Abdominal Abdominal

pain pain PainPain

Liver CancerLiver Cancer

High mortality rateHigh mortality rate2 Types:2 Types:

PrimaryPrimary MetastaticMetastatic

Symptoms:Symptoms: Back pain Back pain Gastrointestinal bleeding Gastrointestinal bleeding Fever Fever Shoulder pain Shoulder pain


ChlamydiaChlamydia

Most commonly sexually transmitted; Most commonly sexually transmitted; it is a disease caused by the bacteria it is a disease caused by the bacteria Chlamydia trachomatis. Chlamydia trachomatis.

Symptoms:Symptoms: Loss of appetite Loss of appetite Weight loss Weight loss Discharge from anus Discharge from anus Fertility problem Fertility problem


CirrhosisCirrhosis

Scarring of the liver and poor liver Scarring of the liver and poor liver function as a result of chronic liver function as a result of chronic liver disease.disease.

Symptoms:Symptoms: Blood in stool Blood in stool Swollen feet Swollen feet Problem getting an erection Problem getting an erection Cannot sustain an erection Cannot sustain an erection


Left Upper Quadrant Pain Left Upper Quadrant Pain DiagnosisDiagnosis

SplenomegalySplenomegaly Hiatal HerniaHiatal Hernia GastritisGastritis Gastric CarcinomaGastric Carcinoma Cascade Stomach (congenital & Cascade Stomach (congenital &

rare)rare) Gastric UlcerGastric Ulcer

Source: Healthline.com & Wrongdiagnosis.comSource: Healthline.com & Wrongdiagnosis.com

SplenomegalySplenomegaly

Symptoms:Symptoms: Inability to eat a large mealInability to eat a large meal Pain on the upper left side of the Pain on the upper left side of the

abdomenabdomen HiccupsHiccups


Hiatal HerniaHiatal Hernia

2 Types:2 Types: Sliding (M/C)Sliding (M/C) Para-esophagealPara-esophageal

Leads to GERDLeads to GERD Associated Associated

symptoms:symptoms: heartburn heartburn regurgitation regurgitation nausea nausea

GastritisGastritisInflammation of the stomach lining.Inflammation of the stomach lining.Symptoms:Symptoms: Nausea or recurrent upset stomach Nausea or recurrent upset stomach Abdominal bloating Abdominal bloating Abdominal pain Abdominal pain Vomiting Vomiting Indigestion Indigestion Burning or gnawing feeling in the stomach between meals Burning or gnawing feeling in the stomach between meals

or at night or at night Hiccups Hiccups Loss of appetite Loss of appetite Vomiting blood or coffee ground-like material Vomiting blood or coffee ground-like material Black, tarry stools Black, tarry stools

Source: WebMDSource: WebMD

Gastric CarcinomaGastric Carcinoma

More likely w/familial historyMore likely w/familial historySymptoms:Symptoms: (Often not due to the (Often not due to the

cancer)cancer) Discomfort or pain in the stomach areaDiscomfort or pain in the stomach area Difficulty swallowingDifficulty swallowing Nausea and vomitingNausea and vomiting Weight lossWeight loss Feeling full or bloated after a small mealFeeling full or bloated after a small meal Vomiting blood or having blood in the stoolVomiting blood or having blood in the stool

Source: Source:

Gastric UlcerGastric UlcerSymptoms:Symptoms: Gastric ulcers generally cause a dull aching pain, often right Gastric ulcers generally cause a dull aching pain, often right

after eating. after eating. Making a meal can often cause an increase in pain Making a meal can often cause an increase in pain Eating will not relieve pain as is the case with other types of Eating will not relieve pain as is the case with other types of

ulcers ulcers Indigestion and heartburn, or acid reflux Indigestion and heartburn, or acid reflux Nagging pain in the upper abdomen area below your Nagging pain in the upper abdomen area below your

breastbone breastbone Episodes of nausea Episodes of nausea A noticeable loss of appetite A noticeable loss of appetite Unplanned weight loss Unplanned weight loss Another less common symptom of a gastric ulcer is that Another less common symptom of a gastric ulcer is that

about 3 in every 10 people are woken up at night by dull about 3 in every 10 people are woken up at night by dull ulcer pains – this usually happens 3- 4 hours after eating. ulcer pains – this usually happens 3- 4 hours after eating.

Source: ulcer-cure.comSource: ulcer-cure.com

Left Lower Quadrant PainLeft Lower Quadrant PainDiagnosisDiagnosis

IntussusceptionIntussusception Sigmoid Colon DiverticulitisSigmoid Colon Diverticulitis Ischemic ColitisIschemic Colitis

IntussusceptionIntussusception

Mostly occurs in babies.Mostly occurs in babies.

Symptoms:Symptoms: Severe abdominal colic Severe abdominal colic Screaming infant Screaming infant Vomiting Vomiting Blood in feces Blood in feces Bowel obstruction Bowel obstruction Source: Wrongdiagnosis.comSource: Wrongdiagnosis.com

Sigmoid Colon Sigmoid Colon DiverticulitisDiverticulitis

Rupture of the colon Rupture of the colon diverticulidiverticuli

Symptoms:Symptoms: abdominal abdominal

crampingcramping constipationconstipation diarrheadiarrhea

Ischemic ColitisIschemic Colitis

Inflammation to part of the colon that can lead to Inflammation to part of the colon that can lead to permanent damage.permanent damage.

Symptoms:Symptoms: Abdominal pain, tenderness or cramping, usually Abdominal pain, tenderness or cramping, usually

localized to the lower left side of your abdomen; the localized to the lower left side of your abdomen; the onset can be sudden or gradual onset can be sudden or gradual

Low-grade fever Low-grade fever Bright red or maroon-colored blood in your stool or, Bright red or maroon-colored blood in your stool or,

at times, passage of blood without stool at times, passage of blood without stool A feeling of urgency to move your bowels A feeling of urgency to move your bowels Diarrhea Diarrhea Nausea Nausea Vomiting Vomiting Source: MayoClinc.comSource: MayoClinc.com

Right Lower Quadrant PainRight Lower Quadrant PainDiagnosisDiagnosis

AppendicitisAppendicitis Meckel DiverticulitisMeckel Diverticulitis Tuberculosis Infection of Terminal Tuberculosis Infection of Terminal

IleumIleum Whipple DiseaseWhipple Disease Cecal DiverticulitisCecal Diverticulitis

AppendicitisAppendicitis

Symptoms:Symptoms: Initially diffuse, Initially diffuse,

poorly localized poorly localized painpain

Loss of appetiteLoss of appetite NauseaNausea VomitingVomiting

Meckel DiverticulitisMeckel Diverticulitis

Occurs mostly in children under 10 Occurs mostly in children under 10 years of age.years of age.

Symptoms:Symptoms: Rectal bleedingRectal bleeding Pain & vomitingPain & vomiting TirednessTiredness WeaknessWeakness

Tuberculosis Infection of Tuberculosis Infection of Terminal IleumTerminal Ileum

Pathologically GI TB is characterized by Pathologically GI TB is characterized by inflammation and fibrosis of the bowel wall and inflammation and fibrosis of the bowel wall and the regional lymph nodes. Mucosal ulceration the regional lymph nodes. Mucosal ulceration results from necrosis of Peyer patches, lymph results from necrosis of Peyer patches, lymph follicles, and vascular thrombosis. At this stage follicles, and vascular thrombosis. At this stage of the disease, the changes are reversible and of the disease, the changes are reversible and healing without scarring is possible. As the healing without scarring is possible. As the disease progresses, the ulceration becomes disease progresses, the ulceration becomes confluent, and extensive fibrosis leads to bowel confluent, and extensive fibrosis leads to bowel wall thickening, fibrosis, and pseudotumoral wall thickening, fibrosis, and pseudotumoral mass lesions. Strictures and fistulae formation mass lesions. Strictures and fistulae formation may occur. may occur.

Source: emedicine.medscape.comSource: emedicine.medscape.com

Tuberculosis Infection of Tuberculosis Infection of Terminal IleumTerminal Ileum

On gross pathologic examination, intestinal TB can be classified into 3 On gross pathologic examination, intestinal TB can be classified into 3 categories:categories:

The ulcerative form of TB is seen in approximately The ulcerative form of TB is seen in approximately 60% of patients. Multiple superficial ulcers are 60% of patients. Multiple superficial ulcers are largely confined to the epithelial surface. This is largely confined to the epithelial surface. This is considered a highly active form of the disease, with considered a highly active form of the disease, with the long axis of the ulcers perpendicular to the long the long axis of the ulcers perpendicular to the long axis of the bowel.axis of the bowel.

The hypertrophic form is seen in approximately 10% The hypertrophic form is seen in approximately 10% of patients and consists of thickening of the bowel of patients and consists of thickening of the bowel wall with scarring; fibrosis; and a rigid, masslike wall with scarring; fibrosis; and a rigid, masslike appearance that mimics that of a carcinoma.appearance that mimics that of a carcinoma.

The ulcerohypertrophic form is a subtype seen in The ulcerohypertrophic form is a subtype seen in 30% of patients. These patients have a combination 30% of patients. These patients have a combination of features of the ulcerative and hypertrophic forms.of features of the ulcerative and hypertrophic forms.


Chronic ileocaecal Chronic ileocaecal tuberculosistuberculosis


Whipple DiseaseWhipple Disease

Whipple's disease is a rare bacterial infection Whipple's disease is a rare bacterial infection that most often affects your gastrointestinal that most often affects your gastrointestinal system. Whipple's disease interferes with system. Whipple's disease interferes with normal digestion, impairing the breakdown of normal digestion, impairing the breakdown of foods, such as fats and carbohydrates, and foods, such as fats and carbohydrates, and hampering your body's ability to absorb hampering your body's ability to absorb nutrients. nutrients.

In addition to affecting your intestinal tract, In addition to affecting your intestinal tract, Whipple's disease can infect other organs, Whipple's disease can infect other organs, including your brain, heart, joints and eyes.including your brain, heart, joints and eyes.

Source: MayoClinic.comSource: MayoClinic.com

Whipple DiseaseWhipple Disease

Common Symptoms:Common Symptoms: DiarrheaDiarrhea Abdominal cramping & painAbdominal cramping & pain Weight lossWeight loss


Whipple DiseaseWhipple DiseaseLess Common Symptoms:Less Common Symptoms: Low-grade fever Low-grade fever Cough Cough Enlarged lymph nodes Enlarged lymph nodes Skin darkening Skin darkening

(hyperpigmentation) in (hyperpigmentation) in areas exposed to the sun areas exposed to the sun and in scars and in scars

Discomfort while Discomfort while breathing, due to breathing, due to inflammation of the inflammation of the membranes lining your membranes lining your lungs (pleurisy) lungs (pleurisy)

Heart murmurs Heart murmurs Enlarged spleen Enlarged spleen

Neurologic Symptoms:Neurologic Symptoms: Difficulty walking Difficulty walking Visual impairment, Visual impairment,

including lack of control of including lack of control of eye movements eye movements

Seizures Seizures Confusion Confusion Memory loss Memory loss


Bilateral Upper Bilateral Upper ConditionsConditions

Acute PancreatitisAcute Pancreatitis Polycystic Kidney DiseasePolycystic Kidney Disease

Acute PancreatitisAcute Pancreatitis

Inflammation of the pancreas.Inflammation of the pancreas.

Symptoms:Symptoms: Abnormal heart rhythms Abnormal heart rhythms Epigastric pain Epigastric pain Aversion to food or drink Aversion to food or drink Abdominal pain radiating to the back Abdominal pain radiating to the back


Polycystic Kidney Polycystic Kidney DiseaseDisease

HereditaryHereditarySymptoms:Symptoms: High blood pressure High blood pressure Back or side pain related to enlarged kidneys Back or side pain related to enlarged kidneys Headache Headache Increase in the size of your abdomen Increase in the size of your abdomen Blood in your urine Blood in your urine Frequent urination Frequent urination Kidney stones Kidney stones Kidney failure Kidney failure Urinary tract or kidney infections Urinary tract or kidney infections

Source: Source: MayoClinic.comMayoClinic.com

Normal Vs. Polycystic Normal Vs. Polycystic KidneyKidney

Bilateral Lower Bilateral Lower ConditionsConditions

Ovarian problemsOvarian problems Abdominal Aortic AneurysmAbdominal Aortic Aneurysm Dissecting AADissecting AA Spine & Pelvic problemsSpine & Pelvic problems

Ovarian ProblemsOvarian Problems

Cysts (congenital)Cysts (congenital) TumorsTumors MumpsMumps EndometriosisEndometriosis OophritisOophritis SalpingitisSalpingitis Ectopic PregnancyEctopic Pregnancy

Source: Source: Wrongdiagnosis.comWrongdiagnosis.com

AAAAAA

Often symptomless.Often symptomless. A deep, boring pain may be present.A deep, boring pain may be present. Felt mainly in the middle of the Felt mainly in the middle of the

abdomen.abdomen. Steady pain that can be relieved by Steady pain that can be relieved by

changing position.changing position. May produce abdominal pulsations.May produce abdominal pulsations. Is often found incidentally w/ Is often found incidentally w/

Ultrasound or CT.Ultrasound or CT.

Dissecting AADissecting AA Occurs when a longitudinal split Occurs when a longitudinal split

appears in the lining of the aorta that appears in the lining of the aorta that separates the middle layer from the separates the middle layer from the intact outer layer.intact outer layer.

3X more common in men.3X more common in men. More common in black men.More common in black men. Less common among Asians.Less common among Asians. ¾ occur in people between 40 & 70 yoa.¾ occur in people between 40 & 70 yoa. Often fatal.Often fatal.

Spine & Pelvic ProblemsSpine & Pelvic Problems

Thoracic Disc BulgeThoracic Disc Bulge Can be confused w/ cholecystitis and Can be confused w/ cholecystitis and

appendicitis.appendicitis. Pelvic Inflammatory DiseasePelvic Inflammatory Disease

Abdominal pain may be accompanied by Abdominal pain may be accompanied by abnormal uternine bleeding, unusual/heavy abnormal uternine bleeding, unusual/heavy vaginal discharge, & painful urination & vaginal discharge, & painful urination & sexual intercourse.sexual intercourse.

Other symptoms include fever, nausea, and Other symptoms include fever, nausea, and vomiting.vomiting.

Sources: vancouverspinedoctor.com & emedicinehealth.comSources: vancouverspinedoctor.com & emedicinehealth.com

ConsultConsult What type of pain are you experiencing? Is What type of pain are you experiencing? Is

the pain throughout your abdomen or is it the pain throughout your abdomen or is it confined to a particular area? confined to a particular area?

Where in your abdomen does the pain seem Where in your abdomen does the pain seem to be located? to be located?

What type of pain are you experiencing? Is it What type of pain are you experiencing? Is it stabbing and severe? Is it a dull ache? stabbing and severe? Is it a dull ache?

When does the pain occur? Always? More When does the pain occur? Always? More often in the morning or at night? If the pain often in the morning or at night? If the pain comes and goes, about how long does it last comes and goes, about how long does it last each time? Does it occur after eating certain each time? Does it occur after eating certain types of foods or after drinking alcohol? types of foods or after drinking alcohol? During menstruation? During menstruation?

ConsultConsult

How long have you had this pain? How long have you had this pain? Does the pain also radiate in your lower Does the pain also radiate in your lower

back, shoulder, groin or buttocks? back, shoulder, groin or buttocks? Are you currently taking any Are you currently taking any

medications or herbal supplements? medications or herbal supplements? Are you pregnant? Are you pregnant? Does any activity such as eating or Does any activity such as eating or

lying on one side relieve the pain? lying on one side relieve the pain? Have you been injured recently? Have you been injured recently?

abdominal pain presented by: jesse ellis. definition abdominal pain is pain that you feel anywhere...

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