Abdominal pain arises from the abdominopelvic viscera, the parietal peritoneum, or the capsules of the liver, kidney or spleen. It maybe acute or chronic, diffuse or localized. Visceral pain develops slowly into a deep, dull, aching pain that's poorly localized in the epigastric, periumbilical, or lower midabdominal (hypogastric) region. In contrast, somatic ( parietal, peritoneal) pain produces a sharp, more intense, and well-localized discomfort that rapidly follows the insult. Movement of coughing aggrevates the pain.
Abdominal pain may also be reffered from another site with the same or similar nerve supply. This sharp, well-localized, reffered pain is felt in the skin or deeper tissues and may co-exist with skin hyperparesthesia and muscle hyperalgesia.
Mechanisms that produce abdominal pain include stretching or tension of the gut wall, traction on the peritonium or messentery, vigorous intestinal contraction, inflammation, ischemia, and sensory nerve irritation.
Action Stat!!!
If the patient is experiencing sudden and severe abdominal pain, quickly take his vital signs and palpate pulses below the waist. Be alert of signs of hypovolemic shock, such as altered mental status, tachycardia, and hypotension. Obtain I.V. access.
Emergency surgery maybe required if the patient has mottled skin below the waist and a pulsating epigastric mass or rebound tenderness and rigidity.
Medical Causes
- Abdominal aortic Aneurysm
- Abdominal cancer
- abdominal trauma
- adrenal crisis
- anthrax, G.I.
- appendicitis
- cholecystitis
- cholelithiasis
- cirrhosis
- chrohn's disease
- diverticulitis
- duodenal ulcer
- ectopic pregnancy
- endometriosis
- gasric ulcer
- gastritis
- gastroenteritis
- heart failure
- hepatitis
- intestinal obstruction irritable bowel syndrome
- listeriosis
- mesenteric artery ischemia
- norovirus infection
- ovarian cyst
- pancreatitis
- pelvic inflammatory disease
- perforated ulcer
- peritonitis
- prostatitis
- pyelonephritis, acute
- renal calculi
- sickle cell anemia
- smallfox splenic infarction
- ulcerative colitis
- drugs like salicylates and NSAID (non steroidal anti-inflammatory drugs)
- place the patient in a position of comfort
- monitor for tachycardia, hypotension, clammy skin, abdominal rigidity, rebound tenderness, a change in in the pain's location or intensity, or sudden relief from the pain since abdominal pain can signal a life-threatening disorder
- administer analgesics as ordered, and evaluate the effect
- withhold food and fluids because surgery maybe needed
- prepare for I.V. infusion and insertion of nasogastric or other intestinal tube
- anticipate the need for peritoneal lavage or abdominal paracentesis
- prepare the patient for diagnostic procedures such as pelvic and rectal examination; blood, urine, and stool tests; imaging studies; barium studies; ultrasonography; endoscopy; and biopsy
- Explain the diagnostic tests the patient will need
- explain underlying disorder and treatment plan
- explain which foods and fluids the patient shouldn't have
- tell the patient to report any changes in bowel habits
- instruct the patient how to position himself to alleviate symptoms
related post:
abdominal rigidity
abdominal masses location
abdominal masses
abdominal distention
detecting ascites
0 comments:
Post a Comment