Acute Abdominal Pain

From Ask Dr Wiki

Contents 1 Intraperitoneal Causes of Acute Abdominal Pain 1.1 Inflammatory 1.1.1 Peritoneal 1.1.2 Hollow visceral 1.1.3 Solid visceral 1.1.4 Mesenteric 1.1.5 Pelvic 1.2 Mechanical (obstruction, acute distention) 1.2.1 Hollow visceral 1.2.2 Solid visceral 1.2.3 Mesenteric 1.2.4 Pelvic 1.3 Hemoperitoneum 1.4 Ischemic 1.5 Traumatic 2 Extraperitoneal Causes of Acute Abdominal Pain 2.1 Genitourinary 2.2 Pulmonary 2.3 Cardiac 2.4 Metabolic 2.5 Endocrine 2.6 Musculoskeletal 2.7 Neurogenic 2.8 Inflammatory 2.9 Infectious 2.10 Hematologic 2.11 Vascular 2.12 Toxins 2.13 Retroperitoneal 2.14 Psychogenic 2.15 Factitious

Intraperitoneal Causes of Acute Abdominal Pain

Inflammatory

Peritoneal

• Chemical and nonbacterial peritonitis
  • Perforated peptic ulcer/biliary tree, pancreatitis, ruptured ovarian cyst, mittelschmerz
• Bacterial peritonitis
  • Primary peritonitis (Pneumococcal, streptococcal, tuberculous; spontaneous bacterial peritonitis)
  • Perforated hollow viscus

Hollow visceral

• Appendicitis
• Cholecystitis
• Peptic ulcer
• Gastroenteritis
• Gastritis
• Duodenitis
• Inflammatory bowel disease
• Meckel diverticulitis
• Colitis (bacterial, amebic)
• Diverticulitis

Solid visceral

• Pancreatitis
• Hepatitis
• Abscess (pancreatic, hepatic, splenic, etc.)

Mesenteric

• Lymphadenitis (bacterial, viral)
• Epiploic appendagitis

Pelvic

• Pelvic inflammatory disease (salpingitis)
• Tubo-ovarian abscess
• Endometritis

Mechanical (obstruction, acute distention)

Hollow visceral

• Intestinal obstruction
  • Adhesions, hernias, neoplasms, volvulus
  • Intussusception, gallstone ileus, foreign bodies
  • Bezoars, parasites
• Biliary obstruction
  • Calculi, neoplasms, choledochal cyst, hemobilia

Solid visceral

• Acute splenomegaly
• Acute heptomegaly (congestive heart failure, Budd-Chiari syndrome)

Mesenteric

• Omental torsion

Pelvic

• Ovarian cyst
• Torsion or degeneration of fibroid
• Ectopic pregnancy

Hemoperitoneum

• Ruptured hepatic neoplasm
• Spontaneous splenic rupture
• Ruptured mesentery
• Ruptured uterus
• Ruptured graafian follicle
• Ruptured ectopic pregnancy
• Ruptured aortic or visceral aneurysm

Ischemic

• Mesenteric thrombosis
• Hepatic infarction (toxemia, purpura)
• Splenic infarction
• Omental ischemia
• Strangulated hernia

Traumatic

Extraperitoneal Causes of Acute Abdominal Pain

Genitourinary

• Pyelonephritis
• Perinephric abscess
• Renal infarct
• Nephrolithiasis
• Ureteral obstruction (lithiasis, tumor)
• Acute cystitis
• Prostatitis
• Seminal vesiculitis
• Orchitis/Epididymitis
• Testicular torsion
• Dysmenorrhea
• Threatened abortion

Pulmonary

• Pneumonia
• Empyema
• Pulmonary embolism (infarction)
• Pneumothorax

Cardiac

• Myocardial ischemia/infarction
• Acute rheumatic fever
• Acute pericarditis

Metabolic

• Acute intermittent porphyria
• Familial Mediterranean fever
• Hypolipoproteinemia
• Hemochromatosis
• Hereditary angioneurotic edema
• Uremia

Endocrine

• Diabetic ketoacidosis
• Hyperparathyroidism (hypercalcemia)
• Acute adrenal insufficiency (Addisonian crisis)
• Hyperthyroidism or hypothyroidism

Musculoskeletal

• Rectus sheath hematoma
• Arthritis/diskitis of thoracolumbar spine

Neurogenic

• Herpes zoster
• Tabes dorsalis
• Nerve root compression
• Spinal cord tumors
• Osteomyelitis of the spine
• Abdominal epilepsy
• Abdominal migraine
• Multiple sclerosis

Inflammatory

• Henoch-Schönlein purpura
• Systemic lupus erythematosus
• Polyarteritis nodosa
• Dermatomyositis
• Scleroderma

Infectious

• Bacterial
• Parasitic (malaria)
• Viral (measles, mumps, infectious mononucleosis)
• Rickettsial (Rocky Mountain spotted fever)

Hematologic

• Acute leukemia
• Acute hemolytic states
• Coagulopathies
• Pernicious anemia
• Other dyscrasias

Vascular

• Vasculitis
• Periarteritis

Toxins

• Bacterial toxins (tetanus, staphylococcus)
• Insect venom (black widow spider)
• Animal venom
• Heavy metals (lead, arsenic, mercury)
• Poisonous mushrooms
• Drugs
• Narcotics withdrawal

Retroperitoneal

• Retroperitoneal hemorrhage (spontaneous adrenal hemorrhage)
• Psoas abscess

Psychogenic

• Hypochondriasis
• Somatization disorders

Factitious

• Munchausen syndrome
• Malingering