Persistent lower abdominal pain

Introduction Severe pain in the abdomen lasted for more than an hour without relief.

Cause

Cause one: ovulatory abdominal pain

Cause two: dysmenorrhea.

Cause three: rupture of the corpus luteum.

Cause four: The ovarian cyst is twisted or broken.

Reason 5: Pregnancy-related diseases.

Cause six: acute appendicitis.

an examination

Ovulation abdominal pain: When adolescent girls ovulate, follicles rupture, follicular fluid may have a certain stimulating effect on the peritoneum, so they sometimes have alternating abdominal pain that is alternating between left and right. This is physiological, and the performance is mostly subsided abdominal pain, dull pain or bulging pain. Some girls are accompanied by a little vaginal bleeding, that is, ovulation bleeding, which disappears after one or two days, usually no more than seven days. This kind of abdominal pain has no pathological changes, and the gynecological examination is completely normal, which is physiological abdominal pain.

Dysmenorrhea: dysmenorrhea is divided into primary and secondary dysmenorrhea. Primary pain is often seen in adolescent girls. The reason is related to prostaglandin levels, cold, emotional and psychological factors in the body without organic lesions. With age, or after marriage and childbirth, they can generally heal themselves. Secondary pain is often seen as endometriosis and adenomyosis. It is characterized by aggravation of pain, more frequent episodes, or a dull pain in the lower abdomen during menstruation and aggravation before and after menstruation. In addition, often accompanied by infertility and menstrual disorders.

Ovary corpus luteum rupture: This is caused by more bleeding in the corpus luteum, accompanied by a sudden onset of abdominal pain in the lower abdomen or one side, and shock can occur in severe cases. Most of the rupture of the corpus luteum occurs in the 20th to 26th day of the menstrual cycle, and there may be pain in the lower abdomen at the time of onset, with varying degrees of severity. Before the rupture of the ovarian corpus luteum, there are processes of ovarian congestion and enlargement. When the ovary is affected by external force or indirect external force, especially during premenstrual hyperemia, it is induced by exertion of force, trauma, sexual intercourse and strenuous activity.

Ovarian cyst pedicle twisted or ruptured: This is because the cyst has a long pedicle, a large volume, no adhesion to the surrounding area, and is highly active, which is reversed when affected by bowel movements or body position changes. When the ovarian tumor is twisted, the pain suddenly occurs on the side of the lower abdomen, which is persistent cramping, often accompanied by nausea and vomiting; the abdomen may have obvious tenderness and muscle tension; the anal finger examination may find enlarged and tender attachments. Ovarian cysts can still rupture, and the contents stimulate the peritoneum to produce severe pain after rupture. B-ultrasound can confirm the diagnosis.

Abdominal pain caused by pregnancy-related diseases can be seen in threatened abortion, ectopic pregnancy (ectopic pregnancy), etc., in the case of ectopic pregnancy, there may be pain or pain in the attachment side of the affected side. When the ectopic pregnancy is aborted or ruptured, it can cause intra-abdominal hemorrhage. . Pain performance varies with how much bleeding and speed. If the tubal pregnancy abortion, abdominal pain is often limited to the lower abdomen side, blood accumulation in the uterus rectum depression, can cause anal pain; when the fallopian tube pregnancy rupture, the amount of bleeding, speed, blood quickly spread to the whole abdominal cavity caused by the full abdomen pain.

Acute appendicitis: It is a common lower abdominal pain in a girl. It is a surgical disease but needs to be differentiated from gynecological diseases. About 70% to 80% of patients begin to feel pain in the upper abdomen or around the umbilicus. After a few hours, they are transferred to the right lower abdomen. The abdominal pain of simple appendicitis is confined to the right lower abdomen and may be persistent or paroxysmal. Suppurative appendicitis increased abdominal pain, mostly with paroxysmal pain or pain. Necrotic appendicitis begins with persistent tenderness, and the range of abdominal pain is enlarged and the degree is increased. In the early stage, there were mild nausea and vomiting foods, often accompanied by loss of appetite and constipation. Bloating occurs when the inflammation is severe. Metastatic right lower abdominal pain is a feature of appendicitis.

Differential diagnosis

(1) Severe episodes of severe pain in the upper abdomen after eating and drinking, should consider perforation of the stomach and duodenum.

(2) Paroxysmal cramps in the right upper quadrant are radiated to the right shoulder, mostly cholecystitis and cholelithiasis.

(3) Severe abdominal pain in the upper abdomen of the upper abdomen, accompanied by vomiting, pain, persistent pain, paroxysmal aggravation, radiation to the lateral waist, acute pancreatitis should be considered.

(4) began to pain in the upper abdomen, a few hours later transferred to the right lower quadrant pain, accompanied by nausea, vomiting, mostly acute appendicitis.

(5) About 6 weeks after menopause, sudden lower abdominal pain with vaginal bleeding, should consider ectopic pregnancy. When women of childbearing age have abdominal pain, they must consider the acute abdomen of gynecology.

(6) Paroxysmal cramps in the flank or lower abdomen, radiated to the lower back, perineum, accompanied by frequent urination, hematuria for ureteral stones.

(7) Abdominal pain with diarrhea, infectious diseases such as enteritis, dysentery, and paracholera should be considered.

(8) Sustained abdominal pain with vomiting may be intestinal obstruction.

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