Local pain in lower abdomen
Introduction
Introduction Local pain in the lower abdomen. It is often expressed as having a tender point, and the tenderness is limited to a little. Clear and fixed tenderness points are important signs of abdominal organ lesions. Such as: tenderness point of peptic ulcer, in the middle or left side of the xiphoid, the penetrating point of the penetrating ulcer in the posterior wall of the ball is in the 6th to 10th thoracic vertebrae or both sides of the back; acute pancreatitis tenderness point, The middle or the left side of the upper abdomen; the tender point of the gallbladder lesion (the gallbladder point), located at the junction of the right rectus abdominis rim and the rib arch; the appendicitis tender point (the appendix point, McBurney point), located in the right anterior superior iliac spine The outer 1/3 of the umbilical cord and the inner 2/3 junction; in the renal and urinary tract lesions, at the 10th rib front end (quarter rib point), the umbilical horizontal line at the outer rectus abdominis (upper ureteral point), two The intersection of the anterior superior iliac spine line with the perpendicular line through the pubic tubercle (middle ureteral point), the outer edge of the spine and the lower edge of the 12th posterior rib (the rib ridge or the rib angle), the 12th posterior rib There is tenderness at the intersection of the edge and the outer edge of the psoas muscle (helping the waist point or the rib waist angle).
Cause
Cause
1. The tenderness caused by abdominal wall lesions is obvious when grasping the abdominal wall or lifting the shoulder on the back.
2. The tenderness caused by intra-abdominal lesions can be caused by inflammation of the organs, congestion, tumors, rupture, torsion, and stimulation of the peritoneum.
3. Common tender points in the abdomen:
1 The gallbladder point tenderness at the junction of the right rectus abdominis and the costal margin marks gallbladder lesions.
2 McBurney point tenderness at the junction of the umbilical cord and the right upper anterior superior iliac spine line at the junction of the anterior superior iliac crest suggests a appendix lesion.
The 3rd rib point (pre-kidney point) is located at the front end of the 10th rib and is the position of the renal pelvis.
4 The upper ureteral point is on the outer edge of the rectus abdominis on the umbilical level.
5 The ureteral point is on the outer edge of the rectus abdominis on the horizontal line of the anterior superior iliac spine, which is equivalent to the second stenosis of the ureter.
The rib ridge point is located at the apex of the 12th rib and the transverse process of the spine, also called the rib angle, which is the position of the kidney.
7 waist points.
Examine
an examination
Related inspection
Ultrasound examination of gallbladder ultrasound examination of liver disease Ultrasound examination of gastrointestinal diseases
Abdominal tenderness The pain that occurs when the abdomen is pressed from shallow to deep. The site of tenderness is often the lesion:
1 right upper abdomen tenderness, seen in liver, gallbladder, colonic hepatic flexion, ascending colon and kidney lesions.
2 upper abdominal tenderness, found in the stomach, duodenum, liver, gallbladder, pancreas and transverse colon and other diseases.
3 left upper abdomen tenderness, see ten spleen, pancreatic tail, left kidney, colon spleen and descending colon lesions.
4 right waist tenderness, mostly caused by kidney and ascending colon lesions.
5 fat tenderness, seen in small bowel lesions, such as enteritis, intestinal parasitic diseases.
6 left lumbar tenderness, seen in the left kidney and descending colon lesions.
7 has lower abdominal tenderness, more common in appendicitis, can also be caused by ileocecal or right fallopian tube disease.
8 lower abdominal tenderness, seen in bladder and female genital lesions.
9 left abdomen tenderness, seen in the sigmoid colon and left fallopian tube lesions.
In addition, abdominal extra-abdominal lesions such as pneumonia, pleural lesions, myocardial infarction, etc. can also produce abdominal tenderness, should be noted.
Diagnosis
Differential diagnosis
It needs to be distinguished from the following symptoms:
Persistent lower abdominal pain: severe abdominal pain lasted more than an hour without relief.
Lower abdominal pain: Chinese medicine noun refers to the feeling of pain and swelling. It is a characteristic of qi stagnation. Lower abdominal pain is common in menstrual menstruation and various digestive diseases.
Abdominal cramps: Abdominal cramps are often caused by the strong peristaltic contraction of the muscles of the abdominal duct-like organs without the will of the person. Under normal circumstances, the pipe-like organs in the human body are constantly squirming. For example, the stomach is constantly moving and contracting to digest food, pushing the chyme into the small intestine, the small intestine is constantly squirming, absorbing nutrients and moisture, and allowing intestinal contents to the large intestine. Pushing, the large intestine is also constantly squirming while absorbing moisture and excreting waste; the gallbladder and bile duct are also creeping and contracting, storing and secreting bile according to the needs of the human body. Normal peristaltic contraction does not cause abdominal pain, but if you want to overcome the obstruction in the pipeline, it is necessary to strengthen the contraction, and the strong and severe contraction will cause abdominal cramps. Organs capable of producing abdominal cramps include the stomach and intestine (including the appendix), the cystic duct, the hepatic duct, the common bile duct, the pancreatic duct, the ureter, the uterus or the fallopian tube, and the kidney.
Abdominal tenderness The pain that occurs when the abdomen is pressed from shallow to deep. The site of tenderness is often the lesion:
1 right upper abdomen tenderness, seen in liver, gallbladder, colonic hepatic flexion, ascending colon and kidney lesions.
2 upper abdominal tenderness, found in the stomach, duodenum, liver, gallbladder, pancreas and transverse colon and other diseases.
3 left upper abdomen tenderness, see ten spleen, pancreatic tail, left kidney, colon spleen and descending colon lesions.
4 right waist tenderness, mostly caused by kidney and ascending colon lesions.
5 fat tenderness, seen in small bowel lesions, such as enteritis, intestinal parasitic diseases.
6 left lumbar tenderness, seen in the left kidney and descending colon lesions.
7 has lower abdominal tenderness, more common in appendicitis, can also be caused by ileocecal or right fallopian tube disease.
8 lower abdominal tenderness, seen in bladder and female genital lesions.
9 left abdomen tenderness, seen in the sigmoid colon and left fallopian tube lesions.
In addition, abdominal extra-abdominal lesions such as pneumonia, pleural lesions, myocardial infarction, etc. can also produce abdominal tenderness, should be noted.
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