2. Causes Of Abdominal Pain Presented By: MH Emami PSRC conference 10.10.1390

3. Sources Of Pain Foregut Midgut Hindgut Referral pain Radicular pains & neuropathies Skin & musculoskeletal pain Psychological

4. TYPES OF PAIN Abdominal pain may be classified into three categories: Visceral pain Somatoparietal pain Referred pain.

5. PQRST Provocative factors Quality Radiation Severity Time and duration

6. Provocative and Relieving factors Eating Fasting Defecation Position Palpation Movement Psychological stress

7. Quality Sharp Colicky Achy Discomfort

8. Radiation To other organs From other organs

9. Severity Very Severe Moderately Severe Mild severity

10. Chronicity Sudden onset (Hyper acute) Acute Sub acute Chronic

11. Time & Duration Sudden onset or relieve Gradual rising or relieve Duration Day or night Awakening from sleep Related to season Related to a specific period of life (period, menarche, menopause, intercourse, etc.)

12. Concomitant Sign and Symptoms Perspiration Tachycardia Nausea or vomiting Stress, Phobia or anxiety Shock Alarming signs

13. History

15. ENDOSCOPY What is this?

16. ENDOSCOPY ESOPHAGUS Esophagitis,schatzki ring, candidiasis, hiatal hernia

17. ENDOSCOPY DUODENUM,BULB Erosions, ulcer and inflammation

18. COLONOSCOPY RECTOSIGMOID,rectum U.Cgrade 4:loss of vascular pattern, friable mucosa, spontaneous bleeding

19. COLONOSCOPY LEFT COLON, desending colon Fisuring ulcer, U.Cgrade 4:loss of vascular pattern, friable mucosa, spontaneous bleeding

20. COLONOSCOPY Terminal Ileum

22. psyche

23. RAP PMSCPP

24. CAWP

25. Surgery

35. Free Perforation

36. Normal Acute Appendicitis

37. Small Bowel Obstruction

38. volvulus

39. Large incisional hernia as the cause of the small bowel obstruction

42. The extrinsic primary afferent neurons that supply the digestive system. These can be divided into three broad categories: vagal primary afferent neurons (black), thoracolumbar spinal primary afferent neurons (green), and pelvic spinal primary afferent neurons (red).