These two days the circle of friends are hotly debated a flight passengers stomach pain themselves climbing into the ambulance thing, the news said the passenger is an intra-abdominal hernia combined with acute intestinal obstruction, resulting in small intestine necrosis. This situation is very critical, if not removed in time, the necrotic intestine can cause infectious shock, or even death.
Pain is the body’s signal for us to seek help in time, so what to do when faced with severe abdominal pain? As the saying goes, it’s better to ask for help than to ask for help, and it’s better to count on the airlines than to gain some knowledge!
What’s wrong with my stomach pain?
There are many causes of severe abdominal pain, and several words that look familiar to you, but you don’t know what they are, can be the cause of your stomach pain, such as acute intestinal obstruction, acute appendicitis, acute pancreatitis, acute cholecystitis, ectopic pregnancy, gastroenteritis, gastrointestinal perforation, urinary stones, incarcerated hernia, vascular lesions or infections of unknown origin, and so on.
The most common stomach pain in general surgery is intestinal obstruction, and other inflammatory diseases such as appendicitis, pancreatitis, cholecystitis and gastroenteritis cause abdominal pain.
Gastrointestinal ulcers used to cause more abdominal pain, but nowadays, people pay more attention to gastrointestinal diseases and take medication in time, so ulcer perforation is less common.
As for ectopic pregnancy, nowadays, medical conditions are better and people pay more attention to ectopic pregnancy, and most of them are treated in time, so abdominal pain caused by it is relatively less common.
If you have rheumatic heart disease, or patients who have had heart stent surgery, as well as people with high blood pressure, coronary heart disease and other high-risk factors, you may develop mesenteric vascular thrombosis (a disease you may not even have heard of.) that causes ischemia in the mesenteric vessels and causes abdominal pain.
8 kinds of stomach pains in the right place
A burst of colic
Presumed cause: intestinal obstruction
Serious consequences: intestinal perforation, intestinal necrosis, shock
The stomach pain caused by intestinal obstruction is mainly a burst of colic, the whole stomach will also be inflated like gas, some patients will also vomit, not put “poof”, nor “mmmmm”, the whole intestine is like being blocked. If the colic becomes persistent and more painful than the other, it may turn into more serious strangulated intestinal obstruction.
There are many causes of intestinal obstruction, including constipation, inflammation, mechanical obstruction (extra-intestinal compression, intestinal overlap, intestinal torsion, and foreign body obstruction), and intestinal tumors. If left untreated, it can lead to intestinal perforation, intestinal necrosis, infectious shock, and even death.
The right side of the small stomach hurts and moves around
Presumed cause: appendicitis
Serious consequences: appendix perforation and abscess
In appendicitis, the pain usually changes places as it goes on. The most typical one starts from the top of the stomach and gradually moves down to the area around the navel, and finally moves to the right side of the belly, that is, the lower right abdomen, where it sets up camp and hurts hard. The characteristic of the disease is that once the pain moves to the right lower abdomen, the parts that have been in pain before do not hurt. Moreover, most patients have a low fever, even in septic appendicitis, which does not exceed 38°C. If the fever is high, it is likely that appendicitis perforation or even peritonitis has occurred.
Appendicitis can cause complications such as perforation and periappendiceal abscess if left untreated.
Stomach pain after eating and drinking a lot
Presumed etiology: pancreatitis
Serious consequences: abscess, infection, death
Stomach pain caused by pancreatitis often occurs after eating a lot of greasy food or after drinking a lot of alcohol. The pain is usually located in the upper middle part of the stomach, and sometimes it radiates to the waist and back whoosh. The degree of pain varies from person to person, from a dull ache in mild cases to a constant cramping in severe cases.
Mild pancreatitis has no complications, but severe pancreatitis can cause pancreatic abscesses and may cause abdominal infections and multi-organ failure. It is important to note that the mortality rate of severe pancreatitis is high and can reach 40% to 50% if not controlled early.
Knife-like cramps on the right side of the stomach
Presumed cause: cholecystitis
Serious consequences: perforation
The pain caused by acute cholecystitis is located on the right side of the stomach, and the patient will feel the pain like a knife cut (imagine a sharp knife spinning and jumping in the stomach…) The pain may be accompanied by nausea, vomiting and fever, usually below 38.5 degrees, and in some cases, a radiating pain in the right shoulder.
Untreated cholecystitis may result in gallbladder perforation and peribiliary abscesses and liver abscesses, but such serious consequences are relatively rare.
Pain throughout the stomach in women of childbearing age
Presumed cause: ectopic pregnancy
Severe consequence: haemorrhage
The pain caused by ectopic pregnancy is pain throughout the stomach. Before the ectopic pregnancy ruptures and bleeds, the patient will feel especially painful, and after the rupture and bleeding, the pain will feel a little lighter instead.
The most common complication of ectopic pregnancy is bleeding in the abdominal cavity. With the improvement of medical conditions, the mortality rate of ectopic pregnancy is not so high anymore, but once it strikes, the condition is usually more dangerous.
Pain in the lower back and abdomen, and pain in the lower body
Presumed cause: urinary calculi
Severe consequences: shock
The most typical symptoms of urinary stones are renal colic and hematuria. If one side of the lower back and abdomen is suddenly super painful, and the pain is also radiating along the ureter to the lower part of the body (testicles, scrotum, labia majora), it is very likely to be renal colic. Renal colic is mainly caused when a stone in the kidney falls into the ureter and moves down the ureter to be discharged.
The pain is particularly sudden and intense, and can last from a few minutes to several minutes, or in some cases, several hours. During an attack of pain, the patient may also become nauseous and vomit, sweat profusely, turn pale, toss and turn, and in severe cases, go into shock.
Severe pain with a bump on the stomach
Presumed cause: incarcerated hernia
Severe consequences: ischemic necrosis of the intestinal wall
A hernia is when a part of the body leaves its place and burrows into another place. The area where the hernia occurs usually has a bulge, so it is easy to detect. A hernia is not painful and sometimes there is a feeling of falling down and soreness, but if an incarcerated hernia occurs, the patient will have severe pain. The so-called ingrown hernia is that it burrows into someone else’s territory and ends up stuck and can’t go back. This pain starts with a burst, and then it hurts so much that it can’t stop. In addition to severe pain, the patient will also experience symptoms of intestinal obstruction such as vomiting, stopping exhaustion and stopping defecation.
If it is the intestinal canal where the impaction occurs and it is continuously stuck, the intestine will necrotize because there is no blood supply, and the consequences are very serious.
Sudden stomach cramps in people with cardiovascular disease
Presumed cause: mesenteric vascular embolism
Severe consequence: intestinal necrosis
The abdominal pain caused by mesenteric vascular embolism is very severe and persistent, often in the upper abdomen, around the navel or right upper abdomen, and the patient often has nausea, vomiting and diarrhea. The pain is usually sudden and without warning, and it is difficult to relieve the pain with antispasmodic drugs.
This disease can cause extensive intestinal necrosis if not treated in time, so it is still very dangerous. Patients with cardiovascular disease must be more careful and go to the hospital as soon as symptoms appear.
Take painkillers blindly, it will affect the diagnosis oh
Once there is severe abdominal pain, before the cause is clear, do not blindly use painkillers, doctors have to judge the patient’s condition according to the nature and location of the pain, arbitrary use of painkillers is to cover up the truth oh.
Only patients with a clear diagnosis of urinary stones or biliary colic or renal colic can take some antispasmodics to relieve the pain before going to the hospital, but if the bloating and abdominal pain continue to worsen and nausea and vomiting appear, do not brace yourself and come to the hospital as soon as possible is the way to go.
What tests should be done when you arrive at the hospital?
① Routine examination of blood, urine and feces: for example, an increase in white blood cells in the blood suggests inflammation; a large number of red blood cells in the urine suggests possible urinary stones, etc.
②Blood biochemical examination: if pancreatitis is suspected, we should check whether there is an increase in amylase.
(③) examination of abdominal puncture fluid: when the cause of abdominal pain is not clear and the patient is found to have fluid in the abdominal cavity, it is necessary to draw out the fluid from the patient’s stomach to check what is going on.
④X-ray examination: usually a standing x-ray of the stomach is taken to see if there is any gas or fluid.
⑤B ultrasound and CT examination: important for the diagnosis of liver, biliary and pancreatic diseases.
⑥Women of childbearing age will also be checked for HCG: to determine if the pregnancy is ectopic.
What will be the treatment when you arrive at the hospital?
The doctor will take the next step of treatment according to the different causes and severity of the patient’s condition.
In case of ectopic pregnancy, the patient will be transferred to gynecology; in case of urinary stones, the patient will be transferred to urology for lithotripsy; in case of cholecystitis or pancreatitis, the patient will be asked to fast and abstain from water to treat the inflammation first, and if necessary, surgery will be done in the emergency room; in case of non-returnable hernia or incarcerated hernia, surgery must be done in time.