Surgical causes of abdominal pain
Pain is the brightest symptom of any trouble in the body.Thus, the body signals the consciousness "Attention!There was a catastrophe!Save! "Unfortunately, it's much more difficult to cope with the pain in the stomach than, for example, with the sensations of a finger burn.Therefore, you should know what it can be, why it arises and who to seek treatment for.Contents: What is the pain in the lower abdomen Where does it hurt?When did you get sick?Was this pain first?The nature of the pain in the abdomen Surgical causes of pain in the lower abdomen Appendicitis Terminal Ileitis, or Crohn's disease Diverticulitis Ulcerative colitis Intestinal tumors Mesenitic Adhesive disease
What is the lower abdominal pain
For a full understanding of the situation, doctors will necessarily ask some questions about the pain:
- Where does it hurt?
- When did you get sick?
- Did this pain occur for the first time, or has it happened before?
- How does the patient feel this pain?
In addition, it is important to find out the specific features of the increase in pain, the movement of the pain point from place to place, the additional symptoms that arise along with the pain syndrome, etc. The information obtained from an experienced specialist will certainly form an integral picture and additional diagnostic measures will only confirmPrimary assumptions.
Where does it hurt?
Physicians conditionally divide the abdomen into three floors, each of which has specific organs.Each floor is also divided into three areas. Below the abdomen there are:
- right iliac;
- left iliac region.
In the right ileum there is a cecum with a vermiform appendage leaving it, and also the end part of the small intestine.
In the left ileum there is a sigmoid colon, as well as part of the jejunum and ileum.
The loops of the small intestine are also located above the pubis, but with a filled bladder it also protrudes into this area.Also, during pregnancy, the uterus emerges into the suprapubic region.
In front, the lower abdomen is bounded by the straight and oblique abdominal muscles, and the back - the spine and muscles of the lumbar region.
Usually if the pain occurs, for example, above the pubis, then the organ that called it is in the same area.However, deviations from this rule are also possible.
When did you get sick?
For the diagnosis it is important to connect the onset of pain with an event in the life of the patient.For example, with some gynecological diseases, pain in the lower abdomen can occur after sexual intercourse.
In addition, the knowledge of the moment of the onset of pain can make assumptions about what is happening in the abdomen at the present time.So if a person suffered stomach pain for 3-4 days, the probability of appendicitis is extremely small - during this time the patient would either die or be in critical condition.
Did this pain occur for the first time?
If exactly the same pain sensations arose earlier, then there is a possibility that the process is chronic.This knowledge allows you to change the tactics of treatment and, often, avoid unnecessary surgery.
The nature of the pain in the lower abdomen
The nature of the pain is perhaps the main criterion, which any doctor can find out in detail.Pain can be:
- is light or, on the contrary, intense, etc.
By carefully analyzing the nature of pain, you can make a fairly accurate assumption of its causes and prescribe adequate treatment.
Surgical causes of abdominal pain
There are a number of surgical diseases that lead to pain in the lower abdomen.Some of them are an indication for immediate surgery, others can be treated conservatively.This is the most dangerous category of diseases, since at any time they lead to the development of life-threatening complications.
This disease is most known and most underestimated by "mere mortals".Often people do not attach importance to moderate pain in the right ileal region until the situation begins to seriously deteriorate.
With appendicitis, pain is initially constant, often occurs in the upper abdomen or near the navel, simulating the symptoms of gastritis or intestinal colic.After a few hours, the pain sensations move to the right iliac region, where they become burning, prickling or pressing.Coughing, straining, abrupt movements and walking strengthen them, forcing the patient to take a forced position - half-bent with a hand pressed to the sore spot.In bed, the patient always lies in the fetal position on the right side - so the pain decreases.
In almost all cases of acute appendicitis, the patient is shown an emergency operation.To delay with diagnosis and treatment is impossible - at some point the appendix breaks and its contents pour out into the cavity of the peritoneum, provoking peritonitis - a severe complication with very high mortality.
Terminal Ileitis, or Crohn's Disease
In this disease, for reasons unknown to science, there is a pronounced inflammation of the ileum wall.The nature of the pain, its intensity and location exactly repeat the clinical picture of acute appendicitis, which often even experienced surgeons "take the patient" on the table.Only at the time of the operation it turns out that the appendix is "healthy", but there are changes in the ileum, which is not always the case with the terminal ileitis.
At the initial stage of the disease, doctors usually dispense with medical therapy with salicylates, immunomodulators, immunosuppressants and symptomatic drugs that fight diarrhea, pain, anemia.In parallel with this, the diet excludes rough dietary fibers, uses foods rich in vitamins.
Practice shows that 30% of patients in the first 10 years are brewing the need for surgical intervention.In this case, the removal of the affected part of the intestine is most often performed.
Diverticulum is a proliferation of the intestinal wall that resembles a sac.When stagnant food in this formation, inflammation may occur.If the diverticulum is located in the region of the cecum or lower part of the ascending colon, the pain of the pulling character will be felt in the same place as in appendicitis., That is, in the right ileal region.
The usual tactic for treating diverticulitis is antibiotic therapy and taking anti-inflammatory drugs.However, drugs can not eliminate the true cause of the disease - the diverticulum itself.Therefore, it can periodically exacerbate, repeatedly putting the patient on a hospital bed.A radical method of controlling diverticulitis is surgical removal of the diverticulum.
This disease affects the large intestine.Pain in the lower abdomen is localized with inflammation of the initial or terminal segments of the large intestine. In parallel with this symptom, the patient has:
- chair disorders;
- appearance of pathological inclusions in fecal masses( mucus, blood);
- loss in weight.
As with terminal ileitis, medicament methods are used here at the initial stage.Only in case of complications or low effectiveness of medicines, the attending physician can recommend the operation.
Oncological diseases of the intestine are relatively rare manifesting clearly localized pain.Often both about the tumor and the patient, and the doctor is only recognized during surgery for intestinal obstruction.However, when squeezing or sprouting tumors of neighboring pain organs, they can still appear quite early.
For oncological pathology, the whole spectrum of antitumor activities is applied:
- Radiation therapy;
- use of immunosuppressants;
- surgery to remove the tumor( if it is technically possible).
Although the treatment of this disease is practiced by surgeons, however, it is treated exclusively by therapeutic methods.Mezadenitis is manifested with severe pains in the lower abdomen on the right - in the right ileal region, with nausea, vomiting, and unexpressed symptoms of intoxication.This disease repeats the clinical picture of appendicitis so precisely that it is often only on the operating table that it turns out that the appendix is in order, and the cause is in the inflammation of the lymph nodes of the abdominal cavity.
Extremely conservative.Anti-inflammatory drugs, antibiotics, anesthetics are used.Surgical intervention in uncomplicated course of the disease is not necessary, but with the development of abscesses or peritonitis, doctors can prescribe an emergency operation.However, before this comes so rarely that most surgeons for all their practice to operate a patient with mesazenite is not necessary.
Pain here can be localized anywhere in the abdomen, but due to the fact that it is caused most often by pelvic organs and surgery for appendicitis, its usual location is the lower abdomen.Pain in the lower abdomen on the left or on the right while pulling, stitching, often accompanied by bloating and constipation.
Conservative treatment is ineffective.At the peak of pain sometimes help antispasmodics, but the most effective is the surgical dissection of adhesions.The operation helps prevent and the development of intestinal obstruction - a dangerous complication, sometimes leading to the death of the patient.
Pain is often the only sign of a so-called "catastrophe" in the abdomen.If it does not disappear within a short time, it means that something bad is happening in the body.Doctors of "first aid" on calls related to abdominal pain follow a simple rule: is "better than diagnosis than underestimation of symptoms" .Guided by them and you, and then do not miss the onset of a serious illness.
The three most important and most dangerous causes of pain in the abdomen are told by surgeons:
Volkov Gennady Gennadievich, medical columnist, ambulance doctor.