Abdominal pain is a common clinical symptom and one of the common reasons for patients to seek medical advice. There is a popular saying that “stomach pain is not a disease, it is just a failure to poop”, which means that most abdominal pains are caused by gastrointestinal dysfunction and inflammation, and will not endanger patients’ lives. But some abdominal pain may be the first manifestation of some serious diseases, if not timely detection, treatment may endanger the lives of patients, the following to introduce you to several potentially life-threatening abdominal pain as the main manifestation of the disease, I hope to draw attention to: a coronary heart disease (acute myocardial infarction, angina pectoris) First of all, the most common and most fatal is the abdominal pain caused by acute myocardial infarction, about 8 percent of In the early stage of myocardial infarction, it can be manifested as sudden onset of severe pain in the upper abdomen, accompanied by nausea and vomiting, with or without localized pressure pain, which can be easily mistaken for stomach pain or cholecystitis. Therefore, middle-aged and elderly patients with previous history of coronary heart disease and angina pectoris, and a few patients may have no history of coronary heart disease, suddenly appear with severe pain in the upper abdomen, so persistent abdominal pain should definitely first have an electrocardiogram to exclude acute myocardial infarction, and electrocardiogram is the easiest and most effective way to exclude heart attack. There may also be abdominal pain when angina is present. In angina, coronary blood flow decreases, myocardial ischemia and hypoxia, and excessive accumulation of metabolites in the myocardium, such as lactic acid, stimulates the afferent nerve endings of the autonomic nerves in the heart, producing a painful sensation that manifests as epigastric pain, which often shows activity-related and can be relieved by rest, and a few will show resting epigastric pain, which is easily misdiagnosed as acute gastroenteritis. Because the pain of these diseases are visceral nerve conduction. Aortic coarctation The maternal death at the North Medical Center that was the cause of so much fuss was due to this disease, which is also often misdiagnosed because of the complex and variable clinical presentation. Aortic coarctation is mostly seen in patients with a previous history of hypertension, where the aortic wall breaks through a fissure and the high velocity and high pressure blood flow enters the mid-membrane of the aortic wall through the fissure, peeling off two layers of the originally tightly packed wall, which can get bigger and bigger without timely treatment. If it breaks into the abdominal cavity to lose blood and die, or if it continues to rise and tear into the pericardium it will cause sudden death. Persistent tearing-like pain is a characteristic symptom of the disease, and more than 90% of patients have sudden onset of severe, persistent and intolerable pain. The site of pain sometimes suggests the site of the tear, and although chest pain is common, there is also low back pain and abdominal pain that may radiate to the lower extremities. Inconsistent pulsation of the radial artery or dorsalis pedis artery bilaterally, significantly weakened or absent pulsation on one side, and a difference in blood pressure of more than 10 mmHg between the limbs bilaterally are characteristic manifestations of this disease. In middle-aged and elderly patients with previous hypertension, persistent tearing abdominal pain with low back pain, along with inconsistent pulsation of bilateral dorsalis pedis arteries, this condition should be especially considered, and most of them need CT examination to further confirm the diagnosis. Third, mesenteric artery embolism is usually caused by dislodged atrial fibrillation thrombus, with severe abdominal pain but no obvious signs on abdominal examination. Disproportionate persistent abdominal pain with nausea and vomiting is the first symptom, and pain medication is ineffective, mostly secondary to atrial fibrillation. Patients with atrial fibrillation who have a combination of 2 or more risk factors such as advanced age (75 years or older), hypertension, diabetes mellitus and heart failure, or who have a history of previous thrombosis, are prone to the formation of thrombus in the atrium, and if the thrombus is dislodged, it will most commonly embolize the cerebral artery causing cerebral infarction, or it may embolize the mesenteric artery causing abdominal pain, and if not treated in time, it will develop into intestinal necrosis or even multi-organ If left untreated, it can develop into intestinal necrosis or even multi-organ failure and death. Patients with a history of atrial fibrillation and the above symptoms should be highly suspected of embolism-induced intestinal necrosis and need CT or angiography for diagnosis or exclusion. Abdominal aortic aneurysm is not a “tumor” in the usual sense, but its threat to health is no less than any kind of malignant tumor. Aneurysm is an arterial dilatation disease caused by degeneration of the arterial blood vessel wall, just like a thinning of a pipe partially bulging a bag, if the aneurysm once ruptured, arterial blood will gush out from the rupture, resulting in sudden death due to massive blood loss. Therefore, abdominal aortic aneurysm is often referred to as a “time bomb” in the belly. Patients with this disease usually have a history of hypertension and atherosclerosis. Acute pancreatitis Most acute pancreatitis has a sudden onset, manifested as severe epigastric pain, and mostly radiates to the back of the shoulder, the patient feels a “girdling sensation” in the upper abdomen and lower back. The location of abdominal pain is related to the location of the lesion, for example, if the lesion in the head of the pancreas is heavy, the abdominal pain is mainly in the right upper abdomen and radiates to the right shoulder; if the lesion is in the tail of the pancreas, the abdominal pain is heavy in the left upper abdomen and radiates to the left shoulder. The intensity of pain is consistent with the extent of the lesion. If it is edematous pancreatitis, the abdominal pain is mostly persistent with paroxysmal aggravation, which can be relieved by acupuncture or injection of antispasmodic drugs; if it is hemorrhagic pancreatitis, the abdominal pain is very intense, often accompanied by shock, and it is difficult to stop the pain by the usual pain relief methods. The disease may have previous biliary system diseases, often triggered by eating too much fatty food and drinking alcohol. In addition; common emergencies such as acute cholecystitis, perforation of the digestive tract, acute obstruction or torsion of internal organs often also have abdominal pain as the first manifestation. The main purpose of introducing these diseases is to let you know that a simple abdominal pain also hides a sinister disease behind it. We hope you understand that if severe and persistent abdominal pain occurs, you must not ignore it and should go to the hospital for examination in time to avoid delaying the diagnosis and treatment and having an accident. If you have friends around you who have similar persistent abdominal pain that cannot be relieved, do not take it lightly, but pay great attention to it and go to the hospital immediately.