1. Presented by: Jesse Ellis
Abdominal Pain
Presented by:
Jesse Ellis

2. Definition
Abdominal pain is pain that you feel anywhere between your chest and groin.

3. Alternative names include:
Stomach pain
Belly ache
Abdominal cramps

4. Characteristics
Abdominal pain can be sharp, dull, stabbing, cramp-like, knifelike, twisting, or piercing. Many other types of pain are possible.
Abdominal pain can be brief, lasting for a few minutes, or it may persist for several hours and longer. Sometimes abdominal pain comes on strongly for a while and then lessens in intensity for a while.
Sometimes abdominal pain can hurt so much that the patient may throw up, with no respite in the pain. Other times, vomiting eases the pain.
Abdominal pain can make the patient want to stay in one place and not move a muscle. Or the pain can make them so restless they want to pace around trying to find "just the right position."
Source: Abdominal Pain in Adults

5. Causes Excessive Gas Lactose Intolerance IBS Indigestion/Heartburn
Gastroesophageal Reflux (GERD)
Cholecystitis
Appendicitis
Bowel Obstruction
Food Allergy
Food Poisoning
Hernia
Viral Gastroenteritis
Kidney Stones
UTI
Pancreatitis
Intussusception
Dissecting Aortic Aneurysm
Parasite Infection (Giardia)
Sickle Cell Crisis
Chron’s Disease
Ulcerative Colitis
Endometriosis
Uterine Fibroids & cysts
Polycystic Kidney Disease

6. The Fantastic 4

8. Right Upper Quadrant Pain Diagnosis
Cholecystitis
Hepatitis (all forms)
Liver Cancer
Chlamydia
Cirrhosis
Source: Healthline.com

9. Cholecystitis Inflammation of the gallbladder wall. Symptoms: Pain
Nausea
Chronic pain
Feels hot to touch
Source: Healthline.com

10. Hepatitis Hepatitis A Hepatitis B Symptoms: Symptoms: Loss of appetite
Body ache
Pain
Headache
Hepatitis B
Symptoms:
Loss of appetite
Pain
Abdominal pain
Ascites
Source: Healthline.com

11. Hepatitis continued Hepatitis D Hepatitis C Symptoms: Symptoms:
aka Delta Agent
Symptoms:
Loss of appetite
Body ache
Abdominal pain
Pain
Hepatitis C
Symptoms:
Vomiting
Joint pain
Itching
Body ache
Source: Healthline.com

12. Liver Cancer High mortality rate 2 Types: Symptoms: Back pain
Primary
Metastatic
Symptoms:
Back pain
Gastrointestinal bleeding
Fever
Shoulder pain
Source: Healthline.com

13. Chlamydia
Most commonly sexually transmitted; it is a disease caused by the bacteria Chlamydia trachomatis.
Symptoms:
Loss of appetite
Weight loss
Discharge from anus
Fertility problem
Source: Healthline.com

14. Cirrhosis
Scarring of the liver and poor liver function as a result of chronic liver disease.
Symptoms:
Blood in stool
Swollen feet
Problem getting an erection
Cannot sustain an erection
Source: Healthline.com

15. Left Upper Quadrant Pain Diagnosis
Splenomegaly
Hiatal Hernia
Gastritis
Gastric Carcinoma
Cascade Stomach (congenital & rare)
Gastric Ulcer
Source: Healthline.com & Wrongdiagnosis.com

16. Splenomegaly Symptoms: Inability to eat a large meal
Pain on the upper left side of the abdomen
Hiccups
Source: Healthline.com

17. Hiatal Hernia 2 Types: Leads to GERD Sliding (M/C) Para-esophageal
Associated symptoms:
heartburn
regurgitation
nausea

18. Gastritis Inflammation of the stomach lining. Symptoms:
Nausea or recurrent upset stomach
Abdominal bloating
Abdominal pain
Vomiting
Indigestion
Burning or gnawing feeling in the stomach between meals or at night
Hiccups
Loss of appetite
Vomiting blood or coffee ground-like material
Black, tarry stools
Source: WebMD

19. Gastric Carcinoma More likely w/familial history
Symptoms: (Often not due to the cancer)
Discomfort or pain in the stomach area
Difficulty swallowing
Nausea and vomiting
Weight loss
Feeling full or bloated after a small meal
Vomiting blood or having blood in the stool
Source:

20. Gastric Ulcer
Symptoms:
Gastric ulcers generally cause a dull aching pain, often right after eating.
Making a meal can often cause an increase in pain
Eating will not relieve pain as is the case with other types of ulcers
Indigestion and heartburn, or acid reflux
Nagging pain in the upper abdomen area below your breastbone
Episodes of nausea
A noticeable loss of appetite
Unplanned weight loss
Another less common symptom of a gastric ulcer is that about 3 in every 10 people are woken up at night by dull ulcer pains – this usually happens 3- 4 hours after eating.
Source: ulcer-cure.com

21. Left Lower Quadrant Pain Diagnosis
Intussusception
Sigmoid Colon Diverticulitis
Ischemic Colitis

22. Intussusception Mostly occurs in babies. Symptoms:
Severe abdominal colic
Screaming infant
Vomiting
Blood in feces
Bowel obstruction
Source: Wrongdiagnosis.com

23. Sigmoid Colon Diverticulitis
Rupture of the colon diverticuli
Symptoms:
abdominal cramping
constipation
diarrhea

24. Ischemic Colitis
Inflammation to part of the colon that can lead to permanent damage.
Symptoms:
Abdominal pain, tenderness or cramping, usually localized to the lower left side of your abdomen; the onset can be sudden or gradual
Low-grade fever
Bright red or maroon-colored blood in your stool or, at times, passage of blood without stool
A feeling of urgency to move your bowels
Diarrhea
Nausea
Vomiting Source: MayoClinc.com

25. Right Lower Quadrant Pain Diagnosis
Appendicitis
Meckel Diverticulitis
Tuberculosis Infection of Terminal Ileum
Whipple Disease
Cecal Diverticulitis

26. Appendicitis Symptoms: Initially diffuse, poorly localized pain
Loss of appetite
Nausea
Vomiting

27. Meckel Diverticulitis
Occurs mostly in children under 10 years of age.
Symptoms:
Rectal bleeding
Pain & vomiting
Tiredness
Weakness

28. Tuberculosis Infection of Terminal Ileum
Pathologically GI TB is characterized by inflammation and fibrosis of the bowel wall and the regional lymph nodes. Mucosal ulceration results from necrosis of Peyer patches, lymph follicles, and vascular thrombosis. At this stage of the disease, the changes are reversible and healing without scarring is possible. As the disease progresses, the ulceration becomes confluent, and extensive fibrosis leads to bowel wall thickening, fibrosis, and pseudotumoral mass lesions. Strictures and fistulae formation may occur.
Source: emedicine.medscape.com

29. Tuberculosis Infection of Terminal Ileum
On gross pathologic examination, intestinal TB can be classified into 3 categories:
The ulcerative form of TB is seen in approximately 60% of patients. Multiple superficial ulcers are largely confined to the epithelial surface. This is considered a highly active form of the disease, with the long axis of the ulcers perpendicular to the long axis of the bowel.
The hypertrophic form is seen in approximately 10% of patients and consists of thickening of the bowel wall with scarring; fibrosis; and a rigid, masslike appearance that mimics that of a carcinoma.
The ulcerohypertrophic form is a subtype seen in 30% of patients. These patients have a combination of features of the ulcerative and hypertrophic forms.
Source: emedicine.medscape.com

30. Chronic ileocaecal tuberculosis Source: emedicine.medscape.com

31. Whipple Disease
Whipple's disease is a rare bacterial infection that most often affects your gastrointestinal system. Whipple's disease interferes with normal digestion, impairing the breakdown of foods, such as fats and carbohydrates, and hampering your body's ability to absorb nutrients.
In addition to affecting your intestinal tract, Whipple's disease can infect other organs, including your brain, heart, joints and eyes.
Source: MayoClinic.com

32. Whipple Disease Common Symptoms: Diarrhea Abdominal cramping & pain
Weight loss
Source: MayoClinic.com

33. Whipple Disease Less Common Symptoms: Low-grade fever Cough
Enlarged lymph nodes
Skin darkening (hyperpigmentation) in areas exposed to the sun and in scars
Discomfort while breathing, due to inflammation of the membranes lining your lungs (pleurisy)
Heart murmurs
Enlarged spleen
Neurologic Symptoms:
Difficulty walking
Visual impairment, including lack of control of eye movements
Seizures
Confusion
Memory loss
Source: MayoClinic.com

34. Bilateral Upper Conditions
Acute Pancreatitis
Polycystic Kidney Disease

35. Acute Pancreatitis Inflammation of the pancreas. Symptoms:
Abnormal heart rhythms
Epigastric pain
Aversion to food or drink
Abdominal pain radiating to the back
Source: Healthline.com

36. Polycystic Kidney Disease
Hereditary
Symptoms:
High blood pressure
Back or side pain related to enlarged kidneys
Headache
Increase in the size of your abdomen
Blood in your urine
Frequent urination
Kidney stones
Kidney failure
Urinary tract or kidney infections Source: MayoClinic.com

37. Normal Vs. Polycystic Kidney

39. Bilateral Lower Conditions
Ovarian problems
Abdominal Aortic Aneurysm
Dissecting AA
Spine & Pelvic problems

40. Ovarian Problems Cysts (congenital) Tumors Mumps Endometriosis
Oophritis
Salpingitis
Ectopic Pregnancy
Source: Wrongdiagnosis.com

41. AAA Often symptomless. A deep, boring pain may be present.
Felt mainly in the middle of the abdomen.
Steady pain that can be relieved by changing position.
May produce abdominal pulsations.
Is often found incidentally w/ Ultrasound or CT.

42. Dissecting AA
Occurs when a longitudinal split appears in the lining of the aorta that separates the middle layer from the intact outer layer.
3X more common in men.
More common in black men.
Less common among Asians.
¾ occur in people between 40 & 70 yoa.
Often fatal.

43. Spine & Pelvic Problems
Thoracic Disc Bulge
Can be confused w/ cholecystitis and appendicitis.
Pelvic Inflammatory Disease
Abdominal pain may be accompanied by abnormal uternine bleeding, unusual/heavy vaginal discharge, & painful urination & sexual intercourse.
Other symptoms include fever, nausea, and vomiting.
Sources: vancouverspinedoctor.com & emedicinehealth.com

44. Consult
What type of pain are you experiencing? Is the pain throughout your abdomen or is it confined to a particular area?
Where in your abdomen does the pain seem to be located?
What type of pain are you experiencing? Is it stabbing and severe? Is it a dull ache?
When does the pain occur? Always? More often in the morning or at night? If the pain comes and goes, about how long does it last each time? Does it occur after eating certain types of foods or after drinking alcohol? During menstruation?

45. Consult How long have you had this pain?
Does the pain also radiate in your lower back, shoulder, groin or buttocks?
Are you currently taking any medications or herbal supplements?
Are you pregnant?
Does any activity such as eating or lying on one side relieve the pain?
Have you been injured recently?