As a senior general surgeon, more than ten years of medical practice, no doubt become a passionate know-it-all, most of the friends around will consult a few discomfort, but the most or abdominal pain consultation. Some friends will also joke that “you are here to go to the hospital?”. In fact, the diagnosis of the etiology of abdominal pain can be written in a monograph, but it is impossible to describe in detail. The causes of acute abdominal pain in common diseases of general surgery are now sorted out and popularized.
1, acute appendicitis
Acute appendicitis is mostly manifested as right lower abdominal pain, and some patients develop pain in the upper abdomen or around the umbilicus, which will be relieved after a few hours and appear simultaneously with right lower abdominal pain, mostly with nausea and vomiting. Clinical manifestations combined with ultrasound or CT of the appendix area can make the basic diagnosis.
2.Acute cholecystitis
Acute cholecystitis is mostly characterized by nausea and vomiting and pain in the right upper abdomen, mostly after eating greasy food or drinking alcohol.
3.Acute gastroenteritis
Acute gastroenteritis mostly has a history of unclean diet, abdominal pain mostly in the upper abdomen or around the umbilicus, mostly persistent abdominal pain or with paroxysmal intensification, often accompanied by nausea and vomiting, diarrhea, abdominal pain without rebound, some patients can appear fever. Of course some of the acute gastritis will also appear unbearable stomach pain.
4. Acute pancreatitis
Acute pancreatitis mostly occurs after alcohol abuse or overeating, and manifests as pain in the upper abdomen or left upper abdomen, mostly accompanied by vomiting, and no significant relief of abdominal pain after vomiting. CT and amylase of the pancreas can confirm the diagnosis.
5.Gastroduodenal perforation
Acute gastrointestinal perforation can occur with peptic ulcer, which is characterized by sudden onset of severe cut-like pain in the abdomen, hard slab-like abdomen, refusal to press, and rebound pain with full abdominal pressure. Free gas under the diaphragm is seen on abdominal radiographs. Clinical manifestations of acute peritonitis combined with abdominal radiographs or CT can confirm the diagnosis.
6.Gallstone disease
Gallbladder stones, bile duct stones leading to gallbladder stone cholecystitis, acute cholangitis, more epigastric pain, fever, with nausea and vomiting, ultrasound or CT or MRCP can confirm the diagnosis.
7. Ingrown inguinal hernia
Inguinal hernia is mostly manifested as a reversible swelling in the inguinal region, which is painful and non-returnable, and mostly manifests as severe pain in the perineum of the inguinal region. Some of them may even have small intestine perforation or necrosis.
8.Acute intestinal obstruction
Acute intestinal obstruction mostly occurs after overeating or eating undigested food with abdominal pain, nausea and vomiting, and anal stoppage of defecation and exhaustion. Abdominal x-ray is mostly seen in the plane of liquid and gas. Previous history of abdominal surgery, or gastrointestinal tract occupancy is mostly the cause of morbidity.
9.Intestinal mesenteric vascular thrombotic disease
Severe pain in the abdomen with no obvious signs in the abdomen is the characteristic manifestation, mostly caused by hypercoagulable blood or dislodged emboli. It is commonly seen in patients with atrial fibrillation with dislodged emboli and after splenectomy for portal hypertension. Diagnosis can be confirmed by vascular ultrasound or angiography.
The treatment of acute abdominal pain is the specialty of the general surgeon, but it is also the most testing for the general surgeon. There are many different causes of abdominal pain, as well as upper abdominal pain due to heart disease, upper abdominal pain due to lung disease, abdominal pain due to gynecological disease, abdominal pain due to urological disease, and even abdominal pain due to anxiety. It is especially important to seek prompt medical attention for abdominal pain. Very few diseases can be diagnosed by telephone consultation, but most of them need to be seen in a hospital. Please have more patience and respect for the surgeon to diagnose the cause of abdominal pain.