Upper abdominal discomfort

Introduction Abdominal discomfort mainly refers to symptoms such as abdominal pain and bloating. Abdominal pain refers to the lesions of internal and external organs caused by various reasons, and manifests as pain in the abdomen. Abdominal pain can be divided into acute and chronic. The cause is extremely complex, including inflammation, tumors, bleeding, obstruction, perforation, trauma, and dysfunction.

Cause

Eating disorders or digestive and cardiovascular diseases.

(1) stomach, duodenal ulcer, gastritis, stomach cancer.

(2) Small bowel and colon diseases, common intestinal obstruction, appendicitis, enteritis, dysentery, gastrointestinal parasites.

(3) Biliary and pancreatic diseases such as cholecystitis, cholelithiasis, pancreatitis, and pancreatic head cancer.

(4) Acute and chronic hepatitis and liver cancer.

(5) Peritonitis, often secondary to gastrointestinal perforation, rupture of the spleen.

(6) abdominal organs cause abdominal pain, such as early stage of lobar pneumonia, acute inferior myocardial infarction, often misdiagnosed as abdominal organ disease.

an examination

Related inspection

Abdominal plain film abdominal abdomen abdominal auscultation

The patient's self-reported symptoms, abdominal distension and abdominal pain can be combined with gastroscopy.

(1) routine examination of blood, urine, and feces: the total number of white blood cells and neutrophil increase suggest inflammatory lesions, and almost every patient with abdominal pain needs to be examined. A large number of red blood cells in the urine suggest urinary stones, tumors or trauma. Proteinuria and white blood cells suggest a urinary tract infection. Pus and blood will prompt intestinal infection, bloody stools suggest stenotic intestinal obstruction, mesenteric thromboembolism, hemorrhagic enteritis and so on.

(2) blood biochemical examination: serum amylase increased suggestive of pancreatitis, is the most commonly used biochemistry in the differential diagnosis of abdominal pain. Determination of blood sugar and blood ketone can be used to line up abdominal pain caused by diabetic ketosis. Increased bilirubin suggests biliary fatigue. Examination of liver and kidney function and electrolytes is also helpful in judging the condition.

(3) routine and biochemical examination of abdominal puncture fluid: abdominal pain must be performed for abdominal cavity puncture when abdominal pain is diagnosed. The liquid obtained by puncture should be sent for routine and biochemical examination, and if necessary, bacterial culture is required. However, the visual observation of the puncture fluid has been helpful in the diagnosis of intra-abdominal hemorrhage and infection.

(4) X-ray examination: Abdominal X-ray examination is the most widely used in the diagnosis of abdominal pain. The gastrointestinal perforation of free gas found in the armpit can be determined. Intestinal gas expansion, most fluid in the intestine can diagnose intestinal obstruction. Calcification of the sputum can prompt ureteral stones. Lumbar muscle shadows are blurred or disappeared, suggesting peritoneal inflammation or bleeding. X-ray barium meal angiography, or barium enema examination can find gastroduodenal ulcers, tumors and so on. Only in case of suspected intestinal obstruction, taboo meal should be contraindicated. Gallbladder, cholangiography, endoscopic retrograde cholangiopancreatography and percutaneous cholangiography are helpful for the differential diagnosis of biliary and pancreatic diseases.

(5) Real-time ultrasound and CT examination: It plays an important role in the differential diagnosis of liver, gallbladder and pancreatic diseases. If necessary, it can be diagnosed by liver examination such as liver puncture and liver cancer if necessary.

(6) Endoscopy: It can be used for the differential diagnosis of gastrointestinal diseases, which is often needed in patients with chronic abdominal pain.

(7) B-ultrasound: mainly used to check biliary and urinary calculi, bile duct dilatation, pancreas and hepatosplenomegaly. It also has a good diagnostic value for a small amount of effusion, intra-abdominal cysts and inflammatory masses in the abdominal cavity.

(8) Electrocardiogram examination For older patients, an electrocardiogram should be performed to understand the myocardial blood supply and to exclude myocardial infarction and angina pectoris.

Differential diagnosis

Identify digestive diseases and cardiovascular and cerebrovascular diseases.

The patient's self-reported symptoms, abdominal distension and abdominal pain can be combined with gastroscopy.

Abdominal pain may be a disease of the liver, gallbladder, pancreas, gynecological disease or genitourinary organs of the gastrointestinal digestive organs. Mild abdominal pain is mostly caused by small gastrointestinal problems such as indigestion. Sustained severe abdominal pain and no diarrhea can be very serious diseases. Abdominal pain and vomiting, abdominal pain has not been relieved after vomiting, the abdomen softly swells, or the patient is drowsy, unconscious, most likely due to the following very serious diseases.

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