Sudden pain

Introduction Sudden abdominal pain is common in patients with acute abdominal pain. This disease is often caused by diseases of the abdominal or extra-abdominal organs. The former is called visceral abdominal pain, often paroxysmal and accompanied by nausea, vomiting and sweating. Related symptoms, abdominal pain is transmitted by the splanchnic nerve; while the latter abdominal pain is transmitted by the somatic nerves, so it is called somatic abdominal pain, often persistent, and often without nausea and vomiting. The site of abdominal pain is often the location of the lesion. Stomach pain is located in the upper middle abdomen. The pain of hepatobiliary disease is located in the right upper abdomen. Acute appendicitis pain is often at the McBurney point. Small intestine colic is located in the umbilical cord. Colonic colic is often located in the lower abdomen. The bladder pain is located in the upper part of the pubis. Acute lower abdominal pain is also seen in acute pelvic inflammatory disease.

Cause

Causes of sudden pain:

1, acute peritoneal: most often caused by gastric and intestinal perforation, abdominal pain has the following characteristics: 1 pain positioning is obvious, generally located in the site of inflammation, may involve pain. 2 sustained persistent pain. 3 Abdominal pain is often exacerbated by stress, altered posture, coughing or sneezing. 4 tenderness, rebound tenderness and muscle tension in the lesion. 5 bowel sounds disappeared.

2, acute inflammation of the abdominal organs: such as acute gastritis, acute enteritis, acute pancreatitis.

3, hollow organ obstruction or expansion: abdominal pain is often paroxysmal and colic, can be very severe, such as intestinal obstruction, biliary ascariasis, urinary tract stone obstruction, gallstone colic.

4, organ torsion or rupture: pedicled organs (ovary, gallbladder, mesentery, omentum, etc.) can cause strong cramps or persistent pain when acutely reversed. Acute visceral rupture such as liver rupture, rupture of the spleen, rupture of ectopic pregnancy, acute pain and signs of internal bleeding.

5, intra-abdominal vascular obstruction: very rare, abdominal pain is quite intense, mainly in heart disease, hypertension, arteriosclerosis based on superior mesenteric artery embolization, dissection aortic aneurysm.

6, poisoning and metabolic disorders: such as lead poisoning colic, acute hematoporphyria, diabetic ketotoxicosis, often have the following characteristics: 1 abdominal pain is severe without clear positioning. 2 abdominal pain was severe, but it was significantly contrasted with mild abdominal signs. 3 have clinical features of primary disease and laboratory examination features.

7, the pain involved in chest disease: pneumonia, pulmonary infarction, acute myocardial infarction, acute pericarditis, esophageal hiatus hernia, etc., pain can be radiated to the abdomen, similar to "acute abdomen."

8, neurofunctional abdominal pain.

an examination

Related inspection

Blood test EEG examination

Diagnosis of sudden pain:

1. The site of pain: The site of abdominal pain is often the location of the lesion. Stomach pain is located in the upper middle abdomen. The pain of hepatobiliary disease is located in the right upper abdomen. Acute appendicitis pain is often at the McBurney point. Small intestine colic is located in the umbilical cord. Colonic colic is often located in the lower abdomen. The bladder pain is located in the upper part of the pubis. Acute lower abdominal pain is also seen in acute pelvic inflammatory disease.

2, the nature and extent of pain: peptic ulcer perforation often occurs suddenly, showing a sharp knife cut, burning like persistent upper abdominal pain. Biliary colic, renal colic, and colic are also very severe, and the patient is often stunned and uneasy. Drilling under the xiphoid is a feature of biliary aphid obstruction. Sustained extensive abdominal pain is seen in acute diffuse peritonitis. The gastrointestinal crisis of the spinal cord is characterized by severe electric shock.

3, induced factors that aggravate or relieve pain: acute peritonitis abdominal pain is relieved when lying down, abdominal wall pressure or aggravation when changing body position. Patients with lead colic often press. Biliary colic can be induced by a fat meal. Gluttony is the cause of acute gastric dilatation. The role of violence is often the cause of rupture of the liver and spleen. Acute hemorrhagic necrotic enteritis is associated with unclean diet.

an examination

(1) Laboratory examination: white blood cell count indicates whether there is infection, red blood cells, hematocrit to determine whether there is intra-abdominal hemorrhage. A large number of red blood cells in the urine suggest urinary damage or stones.

(2) X-ray examination: the free gas under the armpit indicates that the hollow organ is ruptured, and multiple liquid gas planes or larger liquid gas planes indicate intestinal obstruction.

(3) B-ultrasound: damage to the parenchymal organs, rupture, and occupancy can be diagnosed.

(4) endoscopy: the upper and lower gastrointestinal bleeding can determine the location of the bleeding, the nature of the lesion, but also endoscopic hemostasis treatment.

(5) Diagnosis must be puncture.

Differential diagnosis

Differential diagnosis of sudden pain:

Intractable pain: trigeminal neuralgia, postherpetic neuralgia, disc herniation, intractable headache.

Muscle tone pain is a clinical manifestation of neurasthenia. Neurasthenia is a neurosis characterized by brain and physical dysfunction. It is characterized by emotional excitement but fatigue. It is often accompanied by symptoms such as nervousness, trouble, irritability, and other physiological symptoms such as muscle tension pain and sleep disorders.

Burning pain can be seen in burning neuralgia. Burning neuralgia refers to the main symptoms of severe burning pain in the area consistent with the scope of the injured nerve after a clear nerve injury, manifested as pain abnormalities (heteropathic pain), hyperalgesia, sympathetic dysfunction , blood flow disorders, abnormal sweating, bone and muscle atrophy, and sometimes chronic refractory pain syndrome showing edema changes.

Compression pain: Angina is a group of clinical syndromes in which chest compression pain caused by insufficient coronary blood supply lasts for several minutes. At the time of onset, ECG examination showed that in the lead-based lead, the ST segment was depressed, the T wave was flat or inverted (variant angina was associated with ST-segment elevation), and gradually recovered within a few minutes after the onset.

Persistent pain: It is the feeling that the body tissue is stimulated by various kinds of damage, which often causes the body to avoid these damages. Therefore, it is a warning signal of the body and has a protective effect. However, persistent and intense pain can cause disturbances in physiological functions and even shocks. Any form of stimulation (physical or chemical) that causes a certain intensity can cause pain.

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