Abdominal Pain is a topic covered in the Harrison's Manual of Medicine.

To view the entire topic, please or purchase a subscription.

Harrison’s Manual of Medicine 19th edition provides 600+ internal medicine topics in a rapid-access format. Download Harrison’s App to iPhone, iPad, and Android smartphone and tablet. Explore these free sample topics:

Harrison’s Manual of Medicine - App + Web

-- The first section of this topic is shown below --

Numerous causes, ranging from acute, life-threatening emergencies to chronic functional disease and disorders of several organ systems, can generate abdominal pain. Evaluation of acute pain requires rapid assessment of likely causes and early initiation of appropriate therapy. A more detailed and time-consuming approach to diagnosis may be followed in less acute situations. Table 37-1 lists the common causes of abdominal pain.

TABLE 37-1: SOME IMPORTANT CAUSES OF ABDOMINAL PAIN
Pain Originating in the Abdomen

Parietal peritoneal inflammation

 Bacterial contamination

  Perforated appendix or other perforated viscus

  Pelvic inflammatory disease

 Chemical irritation

  Perforated ulcer

  Pancreatitis

  Mittelschmerz

Mechanical obstruction of hollow viscera

 Obstruction of the small or large intestine

 Obstruction of the biliary tree

 Obstruction of the ureter

Vascular disturbances

 Embolism or thrombosis

 Vascular rupture

 Pressure or torsional occlusion

 Sickle cell anemia

Abdominal wall

 Distortion or traction of mesentery

 Trauma or infection of muscles

Distension of visceral surfaces, e.g., by hemorrhage

 Hepatic or renal capsules

Inflammation

 Appendicitis

 Typhoid fever

 Neutropenic enterocolitis or “typhlitis”

Pain Referred from Extraabdominal Source

Cardiothoracic

 Acute myocardial infarction

 Myocarditis, endocarditis, pericarditis

 Congestive heart failure

 Pneumonia (especially lower lobes)

 Pulmonary embolus

 Pleurodynia

 Pneumothorax

 Empyema

 Esophageal disease, including spasm, rupture, or inflammation

Genitalia

 Torsion of the testis

Metabolic Causes

Diabetes

Uremia

Hyperlipidemia

Hyperparathyroidism

Acute adrenal insufficiency

Familial Mediterranean fever

Porphyria

C1-esterase-inhibitor deficiency (angioneurotic edema)

Neurologic/Psychiatric Causes

Herpes zoster

Tabes dorsalis

Causalgia

Radiculitis from infection or arthritis

Spinal cord or nerve root compression

Functional disorders

Psychiatric disorders

Toxic Causes

Lead poisoning

Insect or animal envenomation

 Black widow spider bites

Snake bites

Uncertain Mechanisms

Narcotic withdrawal

Heat stroke

-- To view the remaining sections of this topic, please or purchase a subscription --