Surveys with pain in the stomach stomach. Abdominal pain

Content

A common cause of appeal to the doctor is the complaints of abdominal pain. Under this symptom, even those diseases that are not associated with the abdominal organs can be masked, so the independent elimination of painful sensations is very dangerous. For possible causes provoking pain syndrome, specify its specific characteristics that are a reason for establishing a preliminary diagnosis.

Why pain in abdominal pain arise

Hollow space in a person's body, located below the diaphragm and accommodating abdominal organs, is called the abdominal cavity. Intraperitoneally (in the cavity of the peritoneum) are such organs such as stomach, gallbladder, spleen, intestines (partially). In a broad sense, the abdominal cavity also includes organs located mesoperitoneally (partially covered with a serous shell - caterinous guts, liver) and in the retroperitoneal space (pancreas and duodenal intestine, kidneys, adrenal glands).

The leading manifestation of many diseases of the abdominal organs is pain syndrome. Fabrics from which internal organs consist are not so saturated by nerve endings as skin cover, therefore are not very sensitive to such external incentives, like cuts, breaks, crushing. The mechanism of the occurrence of pain in the abdominal organs differs from external pain due to the localization of receptors in the muscle sheath of the walls of hollow organs or in the Parenchimatous capsule.

The attacks of stomach pain appear when tensile, the stress of the walls or with excessive cuts of the muscles, which can occur due to various reasons. The pain syndrome arising from the receipt to the central nervous system of impulses from the peripheral region experiencing the effect of irritant factors is subjective, and may mean both the presence of pathologies and the reaction of an unpatogenic body.

Not always the localization of pain indicates diseases of the area where it is felt. In violation of the work of many other organs and systems (heart, urinary sphere, nervous system, etc.), irradiation of sensations in the abdominal cavity can occur. The painful sensations in the abdomen can be a consequence of overeating or the result of strong unrest, during the attack of which adrenaline entering the blood in large quantities leads to a sharp reduction in muscle tissue (spasms).

A distinctive feature of serious health problems on the effects of non-harmony food absorption is the presence of auxiliary symptoms that accompany diseases. If soreness bears a short character and major complaints are reduced to the unpleasant feelings in the abdomen - it is most likely a testimony of the usual overeating or psychological stress. If the condition is exacerbated by diarrhea, nausea, hyperthermia or pain takes a painful nature - this is an occasion to appeal to the doctor and clarify the cause of the appearance of symptoms.

Causes of abdominal pain

The nature and type of pain in the abdominal cavity are not always in direct dependence on the factors causing them. In the interpretation of complaints of patients who applied with abdominal pain, attention is paid to the area of \u200b\u200bits localization, intensity, the presence of associated symptoms, but the final diagnosis is established on the basis of diagnostic surveys. The most common causes of pain in the abdominal cavity detected by the results of the diagnosis are:

inflammatory diseases (with inflammation associated with gluten enteropathy or krone disease, spasms are enhanced before or after emptying the intestines, the high temperature indicates the irradiation of pain in the upper body and disorder of the digestion in the pancreatic processes in the pancreas);
food poisoning of bacterial nature;
the gap of appendicitis (accompanied by non-nestable outbreaks of pain);
the blockage of biliary ducts (blockade of biliary tract is accompanied by a strong fever, a change in the color of excrement);
functional diseases of internal organs and their consequences (irritable bowel syndrome, dysbacteriosis);
dystrophic-inflammatory changes in the gastric mucosa (acute form of gastritis);
dysfunctional kidney disorders occurring under the influence of infectious agents or allergens;
infection of the upper respiratory tract (more often found in pediatric practice);
trophic disturbances of local stations of the stomach or duodenum (peptic disease);
the formation of the concrections in the bustling bubble (the presence of stones provokes spasms in the entire abdominal cavity);
intestinal obstruction (dangerous pathological condition caused by a variety of factors - from invasion with worms to frequent reception of high-calorie foods);
damage, breaks of peritoneal organs;

loss of internal organs from the cavity under the skin (hernia);
pregnancy (characteristic of early terms);
the presence of benign or malignant neoplasms in the body (not necessarily localized in the organs of the peritoneum, painful sensations may arise due to tumor metastasis);
ectopic pregnancy or spontaneous abortion (accompanied by uterine bleeding);
anomalous course of physiological processes (reflux - reverse current of the contents of hollow organs, which can cause the development of gastroenterological diseases);
gynecological, urological diseases;
a decrease in the number of plant food in the diet, insufficient water consumption (the colon disease is developing a diverticulosis, characterized by the formation of pockets (bags of guts on the walls of the intestines), filled with bacteria and bowel content);
metabolic deviations caused by a violation of a hormonal background or a reception of harmful substances (drugs, alcohol);
violations of the blood supply of abdominal vessels;
psychogenic or neurotic factors;
congenital anomalies of internal organs;
the sharp form of migraine (the sickening character of pain, is more often diagnosed in children).

Related symptoms

The study of the diseases of the methods of their treatment is engaged in the study of the etiology of the development of diseases of the gastrointestinal treatise and organs of the abdominal cavity, the section of medicine Gastroenterology. The reason for appealing to the gastroenterologist is a totality of criteria indicating the pathogenic nature of pain. If the nature of the experienced pain can be described by one of the following statements, it should urgently apply for medical help:

causes frequent anxiety;
prevents normal daily activity, performing professional functions;
accompanies weight loss, changing food habits;
the intensity is characterized by such a level at which awakening occurs during night sleep.

One of the important factors indicating the pathogenic nature of pain spasms is the presence of characteristic accompanying symptoms. Based on the complaints of the patient relating to the states accompanying the abdomen, the doctor can make assumptions about the cause of the origin of pain in the abdominal cavity and affected by the authority:

Symptom accompanying pain	Possible provoking diseases (affected organ)
Fever, chills	Intestinal infection, edible poisoning, inflammatory process, infarction, pancreatitis
Depletion	Violation of digestion processes, neoplasms, inflammation development, vascular pathologies (ischemia)
Nausea, vomiting, bloating bloating	Acute intestinal obstruction, infectious or inflammatory lesion, metabolic disorders
Dysphagia (violation of the swallowing process)	Gastroesophageal reflux disease (esophageal damage)
Premature satiety	Gastric pathology
Gematemesis (bloody vomiting)	Defeat of the stomach, intestines (duodenum), esophagus
	Colonial diseases, urinary spheres, intestinal disorders
The yellowness of the skin	Violation of digestion, excretion, liver pathologies, hemolysis of red blood cells
	Infectious intestinal diseases, inflammatory process, digestion disorder, urogenital or vascular pathology
Dysuria (difficulty urination) or hematuria (blood presence in urine), vaginal or urethral discharge	Diseases of the urogenital system
Increased body temperature	Inflammatory processes, diseases of viral, bacterial, infectious nature
Low blood pressure, dizziness, headache, darkening in eyes, weak pulse	Internal bleeding, inflammation of the organs of the urogenital system

What can increase pain

Due to the subjective assessment of the nature and type of pain, history of illness and life of the patient has great importance for the formulation of an accurate diagnosis. During the preliminary examination, the doctor finds out under what conditions the pain appeared, and what affects its current. Strengthening or weakening painful manifestations occurring under the influence of external conditions is often a clarifying factor for identifying the cause of pain syndrome. Abdominal pain can increase due to the following reasons:

meals - indicates the lesions of the upper departments of the gastrointestinal tract, the pancreas or the discrete of biliary ducts;
the act of defecation is the increase in pain during the intestinal emptying occurs due to violations of the straight or colon, before or after the act - due to the disease of the Crown or celiac disease;
urination - problems of the urogenital or colorectal zone;
the process of breathing - if the enhancement of sensations occurs at a deep breath, it may indicate problems of the hepatobiliary system or a pulmonary-pleural region;
changing the body position - severe abdominal pain arising in certain poses, testify to diseases of the pancreas, skeletal muscle pathologies or reflux;
menstrual bleeding - inflammatory tubal formations, the growth of the cells of the inner layer of the uterus (endometriosis);
motor activity - Abdominal syndrome occurring during physical activity signals problems with vessels or violation of the structural structure of transverse muscle tissue;
using inside of some drugs or certain foods - violation of metabolic processes, reflux, allergic reactions, lactose intolerance, food poisoning;
psycho-emotional imbalance is a strong stress, excitement, can cause a violation of nervousormonal regulation, which leads to the predominance of aggressive factors (acid-peptic) mucous membrane of the abdominal cavity over protective.

Types of abdominal pain

The patient may not always accurately characterize the experienced painful sensations, but a qualified doctor with the help of clarifying issues is able to identify typical signs of diseases. To identify the cause of pain, such characteristics are important as the duration of the flow, type (which sensations are dominated), localization (while the place of pain is not always associated with the arrangement of the affected organ), the presence of concomitant symptoms.

The danger of described pain syndrome in the abdominal cavity is evidenced by the duration and nature of pain, but some severe conditions can develop rapidly. One of the common causes of acute sudden pain is an intra-painted catastrophe - a collective concept used to designate a life-threatening states (breakthrough of ulcers, ulcers, cysts, complete blockage of kidney vessels or spleen, intra-abdominal bleeding).

Sharp

Catching sharp abdominal pain is often characteristic of spastic cuts of muscles. Depending on where sharp painful sensations are localized, and what symptoms they accompany, one can judge the possible reason for the appearance of pain syndrome:

Localization area	Possible reason	Concomitant symptomatics
Low belly on the right	The inflammation of the appendix (begins in the navel area and spreads to the right), the formation of concrections in the bustling bubble (acute painful sensations below shift up, gradually subsided), gynecological pathologies (ovarian break)	Chills, hyperthermia, vomiting, bleeding
Top right, right hypochondrium	Diseases of the gallbladder (cholecystitis)	Painness is enhanced after eating, chills, strong temperature rise
Inside the abdomen (top or middle)	Gastroesophageal reflux disease, ulcer	Applying nausea, frequent belching, heartburn, meteorism
Left bottom	Exacerbation of diverticulosis	Nausea, vomiting, cramps, constipation, hyperthermia

Stitching

Such a characteristic of sensations as "stuck" may indicate many diseases, therefore, for the narrowing of the circle of presumably causes of the origin of pain, there is a need to clarify its nature. The acute painful syndrome signals the exacerbation of the existing diseases (the strongest sensations, up to pain, causes a soda ulcer), annoying stomach stiff pain often accompany chronic pathologies:

Localization area	Possible reason	Concomitant symptomatics
Top part	Chronic gastritis	Nausea arising after meals, belching, heartburn, loss of appetite
Starting in the upper part of the abdomen pain spreads first throughout the right side, and then on the whole belly	True ulcer	Bradycardia, surface breathing, increasing blood ripple frequency
Downstairs to the right	Gynecological pathology in women	The tension of the muscular frame of the front abdominal wall, soreness when pressing
	Dead intestinal lesions, inflammation of meckel's diverticula	Disruption of appetite, exhaustion
	Tumors of intestines	Sleep disorders, weakness, exhaustion
	Upper urinary tract diseases	Cause of urination, blood presence in urine
All abdominal area	Intestinal colic (intestinal spasms)	Nausea, vomiting, hyperthermia
At the bottom of the left	Ulcerative colitis	Diarrhea, blood impurities in feces, temperature rise

Noye

On the beginning of the development of gastroenterological diseases warns the new stomach pain. Such a character of sensations and diseases occurring in a chronic form at the remission stage. Depending on the localization of pain, it can act as a sign of such pathologies as:

Localization area	Possible reason	Concomitant symptomatics
The combination of stuffing abdominal pain and stupid - in the lower back	Kidney inflammation	Chills, weakness, change in urine color
Abdomen center at the top	Chronic gastritis	Communication of increased soreness with food reception, periodic constipation, diarrhea
May occur in all departments of the cavity	Malignant tumors, stomach polyps	Worstification of general condition, exhaustion, frequent vomiting, constipation or diarrhea
Nonocalized pain, with concentration at the bottom of the abdomen	Development of an infectious disease	Irradiation in the Lumbar Department
Underbelly	Endometriosis, uterine myoma	Strengthening discomfort during menstruation
Left down	Pathology of the spleen (heart attack, break, expansion)	Raising temperature, vomiting

Constant

The painful sensations in the abdominal region, characterized as permanent or stable, are a consequence of inflammatory processes occurring in the abdominal organs, ulcerative, biliary diseases, abscesses or pancreatitis. Permanent abdominal pain, unlike short-term spasms, are more often a serious sign of pathologies:

Localization area	Possible reason	Concomitant symptomatics
Owning	Malignant pancreas neoplasms	Irradias in the Lumbar Department, decline in appetite, exhaustion
All belly	Polyps of the stomach, oncological diseases	The presence of blood in cartoons or vomit masses
All belly	Peritonitis, inflammation of the peritoness	Weakness, high temperature, nausea, vomit urge
Central and top of the belly	Acute form of pancreatitis	Increased pressure, dry mouth, frequent bouts of nausea and vomiting

Flame

Pain attacks, repeating often, but flowing are not very acute, serve as a reason for appealing to the doctor, only when symptoms are enhanced. Patients who suffer from frequent pains can experience painful sensations for years and do not respond to them. Many of the diseases for which the frequent poorly pronounced painful attacks are characterized relate to functional disorders, and rarely lead to complications, but poorly treatable:

Periodic

If pain then appear, they subside or disappear at all - to determine the cause, it is necessary to clarify the nature of sensations and their relationship with external factors. This type of painful syndrome may indicate diseases of chronic nature or the defeat of the body with infectious agents. To clarify the diagnosis, more often requires additional examinations:

Localization area	Possible reason	Concomitant symptomatics
Left bottom	Diverticulit	Alternation of constipation and diarrhea, bleeding of blood or pus in nuts
Side Belly Side Departments		Frequent calling for defecation, bloating
Different segments	Crohn's disease	Exhaustion, lack of appetite, variational extra-sized symptoms
Lower departments	Endometriosis	Blood selection from the vagina, irradiation of pain in the sacrum area
All belly	Tumors of the stomach, pancreas, large intestines	Symptoms of intoxication, general deterioration

Diagnostics

The primary examination of the patient who turned with complaints of abdominal pain occurs with the use of physical diagnostic methods. During the examination of the patient, the doctor conducts palpation, percussion and auscultation, in the process of which the presumptive region and the severity of pathological changes are revealed. Based on the survey and study of the history, the gastroenterologist establishes a preliminary diagnosis, to confirm that such instrumental and laboratory research methods can be involved:

Clinical blood test is used to estimate the content of hemoglobin, red blood cells, leukocytes, platelets, serum electrolytes. Using a lekogram, the presence of inflammatory processes is determined, controlling the level of electrolytes (potassium, sodium, chlorine) is necessary to identify the pathologies of the heart, kidneys, toxic substances.
Urine Analysis is a non-specific method for identifying the abdominal disease, applied to the differentiation of gastroenterological diseases from urinary infections and pyelonephritis.
Coagulological study (hemostasiogram) - determine blood coagulation to assess the state and functioning of the hemostatic system.
X-ray study - the chest organs are investigated (heart disease, pleura), abdominal cavity, liver (the displacement of the organs, their stretching is estimated, the presence of gases, liquids, and concrections is determined). Radiography can be carried out using a contrast agent to improve the imaging of the anatomical structures of the gastrointestinal tract. Cholangiography (X-ray of biliary ducts) is used to examine the jeliating system), angiography, seven-way ducts - Vazography.
Electrocardiography - used to differentiate pains arising from heart pathologies and irradiating to the abdominal cavity.
Endoscopy is a highly informative diagnostic method that contributes to the study of organs from the inside. VideoFibroezophageastrodenoodenoscopy helps to examine the esophagus, stomach and duodenalist, video fibrocolonoscopy - a large intestine, RectorOnoscopy is the rectum. If necessary, the inspection is carried out by puncture of the abdominal cavity or the rear axle of the vagina (laparoscopy, ventroscopy, abdominoscopy, celocopy).
Gastroduodenoscopy - the procedure is carried out using a gastroscope, it is used to determine disorders associated with the pathologies of the mucous membrane of the esophagus or stomach.
RectorOnososcopy is a study using a rectoroscope of the mucous membrane of the rectum, the cavity of which is previously inflated by air. During the procedure, it is often necessary to take biopsy when discovering suspicious sites.
Ultrasound examination (ultrasound) - due to the lower informativeness of the Echography compared with the endoscopic study of the ultrasound of the stomach, it is rare. This method is more often used to assess the condition of the liver, gallbladder, kidneys.
Computer tomography - It is used to identify the cause of pain, determining the exact localization of pathological changes, helps to detect the neoplasm even at an early stage.
Magnetic resonance tomography - obtaining clear layers of the internal structure of all abdominal organs with a nuclear magnetic resonance. In the presence of testimony, the study can be carried out with intravenous contrast.
Radionuclide scanning is the study of the morphology and functionality of the organs by introducing radiopharmaceutical preparations into the body. The method is used to detect malignant tumors and metastases.

Treatment

Not all kinds of pain indicate the presence of diseases or pathologies requiring treatment, but it is impossible to interpret the manifestations of abdominal pain independently. Even highly qualified specialist can not always determine the cause of pain on the basis of only external manifestations, therefore, in the event of disturbing symptoms, it is necessary to immediately apply to the hospital.

First aid measures in the development of acute painful spasms are reduced to the challenge of the ambulance brigade, before the arrival of which should not be taken medicines in order not to distort the results of the preliminary inspection. The treatment diagram is made only after clarifying the diagnosis and is based on the elimination of the causes of painful sensations in the abdominal cavity.

If, according to the results of the primary inspection, the life-threatening state is diagnosed - it serves as a reason for the urgent hospitalization of the patient and the adoption of urgent therapy. The main emergency measures include:

intravenous administration of medicinal solutions (hydrocarbonate or sodium lactate) to correct the threatening life of the acid-base state;
urgent surgery (with the gap of appendix, hernias, malignant tumors, intestinal obstruction, probulous ulcers and other intra-abdominal catastrophes).

In the absence of a threatening life of symptoms of the patient, treatment is assigned on the basis of the diagnostic studies. Prescribed therapeutic measures can be carried out:

At home - if painful sensations are caused by natural physiological processes (early periods of pregnancy, menstruation) or the initial stage of the development of the disease. The appointment of drugs and therapeutic procedures is carried out on the basis of the revealed cause of pain. Often appointed means are anesthetics, non-nucleic analgesics, antispasmodics.
Under the conditions of the hospital - in identifying diseases of the mild or moderate severity associated or not related to the disorder of the organs of the gastrointestinal tract. Drugs are applied on the basis of the specifics of the diagnosed disease and the nature of its flow. Along with therapy of the underlying disease, drugs are used to relieve pain syndrome.

Video

Found in the text error?
Highlight it, press Ctrl + Enter and we will fix everything!

Abdominal pain can occur under states that require immediate challenge. In other cases, emergency medical care is not obligatory - you can be examined by yourself or contact the precinct therapist. Additional symptoms and localization of pain will be prompted which tests to pass and how urgently need a doctor's intervention.

Palpation

With intense pains in any part of the abdomen, first of all, put the patient on your back and felt the stomach. If the belly surface is solid - almost like a board is a dangerous sign (protective reflex tension of muscles). Another important symptom is if the pain is intensified without pressing a hand on the stomach, but with a sharp assignment of the gulling hand from its surface. Both of these symptoms indicate an extremely dangerous condition called "acute stomach". It combines internal bleeding, breaking of the intestines and peritonitis - inflammation of the peritoneum. All this is a reason for appealing for emergency medical help.

If the heartbeat with pain in his stomach, a shortness of breath was frequent, the pallor appeared, there was plentiful sweat or the pressure dropped, the doctor should also cause immediately - these are signs of serious bleeding. It is not necessary to engage in self-medication and with multiple vomiting and cramps.

If the state is not very difficult, you can begin to be examined yourself. It is necessary to start with a general analysis of blood, especially with a combination of pain with a temperature and liquid chair. The changes in the number of leukocytes, the leukocyte formula and the rate of settlement of the erythrocytes will show if there is inflammation and what it is caused by bacteria or viruses. In addition, the UAC can confirm or refute suspicion of appendicitis.

With stupid pulling pains to the right under the ribs under suspicion it turns out the liver. Additional features - darkening of urine and bleaching feces, nausea, disgust for food. There is also a biochemical blood test for bilirubin and bile pigments, asate enzymes and an alkaline phosphatase.

Pains below the sternum, especially those who are particularly given in the left side of the abdomen, are peculiar to the pancreas diseases. Also characterized by stuffing pains and unpleasant sensations in the field of left blade. In such a situation, a biochemical blood test for amylase is useful.

The cause of abdominal pain can be diseases of the stomach, duodenum and intestines. If a person in the past had any problems with these bodies, it is necessary to conduct FGDS and (for the intestines) of colonoscopy. They will show gastritis, peptic disease, neoplasms - especially if taking a piece of fabric for analysis (biopsy).

FGDS may be accompanied by pH-metry - assessing the amount of hydrochloric acid in gastric juice. It changes with inflammation and on-cancer. The state of motility is investigated, i.e. the movements of the stomach and intestines. Sometimes food can "move in the opposite direction", getting from the intestine in the stomach or from the stomach in the esophagus. At the same time, heartburn often arise, belching with bile or remnants of undigested food.

Visualization techniques

The advantage of ultrasound is harmlessness and low cost. The method allows you to assess the structure and sizes of the organs, the state of their blood supply. In addition, under the abbreviation "Ultrasound Obsites" is hidden at least several organs: liver, gallbladder, pancreas and spleen. Indirectly will be assessed by the state of the stomach and duodenum.

MRI makes it possible a detailed study of the structure of the organs. However, some people with difficulty tolerate finding in closed tomographs, and open-type devices give an image of the worst quality. The disadvantage of CT is the impact on the body of the X-ray, and the advantage is an open device and a smaller duration of the study.

Thus, when drawing up a survey plan, it is necessary to follow a common principle - from simple methods to more complex. In addition, it is necessary to understand: the most likely "culprits" of abdominal pain take part in the metabolism. Therefore, if you decide to take tests yourself, it is best to start with blood tests, which, despite its relatively low cost, are very informative.

Lydia Kulikova

Photo istockphoto.com

5134 0

Diagnostic research

First of all, a general analysis of blood and urine is made in stomach acute pain. It should be emphasized that in the early stages of bleeding, the rate of hematocrit, as a rule, is within the limits of the norm even with a significant blood loss, since for the equilibrium occurrence between the volumes of ins-and-support fluid, it takes several hours.

It is known that the number of peripheral blood leukocytes is not an exact indicator of the acute surgical pathology of the abdominal organs. During the examination of patients subjected to exposive surgical interventions in suspected appendicitis, it was found that in patients with appendicitis or other surgical pathology, on average, the blood cells in the blood is greater than in patients with non-surgical diseases, however, a significant number of patients of both groups, the number of leukocytes was less than 10x10 9 / l. On the other hand, 55% of patients with non-surgical pathology The content of leukocytes exceeds 10x10 9 / l.

The infectious disease of the urinary tract can confirm urine analysis. With urolithiasis in the urine, red blood cells are usually detected, although this is not a mandatory feature. In suspected an ectopic pregnancy, it is necessary to make urine analysis on human choriogonadotropin.

The study of blood amylase is carried out in suspected pancreatitis, but with pronounced pancreatitis, the concentration of amylase can remain within the normal range; This usually happens with an extensive damage to the pancreas. Many other acute diseases of the abdominal organs, such as cholecystitis, intestinal ischemia, perforation and intestinal obstruction, also cause an increase in serum amylase levels.

The radiography of the abdominal organs should be produced in two positions: lying and standing so that you can determine the boundary between the gas and liquid.

Gas and liquid levels indicate mechanical intestinal obstruction, but, in addition, they may be observed with paralytic intestinal obstruction and other diseases of the abdominal organs.

Free gas in the abdominal cavity when the hollow organs is spinning, it is better noticeable on radiographs of the chest, performed in a vertical position. Calcification in the pancreas area indicates chronic pancreatitis. The increase in the radiocontrase of a large lumbar muscle can be observed in massive hemorrhage or abscess formation. Attention should be paid to the presence of stones in the bustling bubble, a worm-like process and ureters.

Radiography is shown not to all patients with abdominal pain. The patient with a threatening disease of the abdominal organs should be made an urgent exposive operation without dangerous delay, inevitable when performing additional research.

In addition, as noted earlier, in most patients with sharp pains in the stomach there are no serious diseases, and the execution of a routine x-ray study is not justified. Often, attentive examination and subsequent careful clinical observation of the patient's condition make it possible to avoid significant material costs for the implementation of numerous radiographs.

The role of special radiological research methods in the diagnosis of acute abdomen is limited. To confirm the diagnosis of stones in a ureteer, posed on the basis of anamnesis, the results of physical examination and urine research, intravenous pyelography can be used.

Studies using barium in acute abdominal pains is not recommended, since it is unsafe in the case of body perforation and, moreover, it makes it difficult to fulfill subsequent urgent diagnostic procedures, such as ultrasound research or angiography. Ultrasound examination can help in the discovery of the gallbladder stones and has a number of advantages, since it is safe, simple and does not require the introduction of a contrast agent.

To diagnose the blockage of bubble duct, the radioisotope scanning of the biliary tract is increasingly used, which is a more valuable indicator of the presence of acute cholecystitis than the detection of stones in the bustling bubble, since in the latter case may asymptomatic flow. Intravenous cholangiography is currently in fact not used.

In case of suspected embolism or thrombosis of the mesenteric artery, arteriography is performed. The diagnosis of intestinal ischemia, the cases of which are recognized increasingly in connection with the increase in the contingent of older patients, is significant difficulties. Again, pre-use of barium prevents arteriography.

If the abdominal aortic aortic aortic is suspected, the need for this procedure disappears and the best way to diagnose in this case is an emergency laparotomy.

Laparoscopy is considered a valuable diagnostic study method, especially in women in the absence of amenorrhea, when it is difficult to distinguish appendicitis from diseases of the small pelvis organs. However, this study was not distributed in the diagnosis of sharp pain in the stomach, in. including me to women.

It is possible to distinguish appendicitis from diseases of the small pelvis organs on the basis of combined surgical and gynecological methods, and sometimes with the help of an additional ultrasound study of the pelvic organs or the Barium Ebiz.

Research with barium-ease can help in diagnosis, if during it defects filling the blind intestine, indicating the increase in appendix. Negative aspects of any study using barium when evaluating acute abdomen should be taken into account before appointing this procedure.

An endoscopic study of the upper gastrointestinal tract undoubtedly increases the accuracy of the diagnosis of peptic ulcers. Unfortunately, this procedure is unpleasant for the patient and requires large material costs. Often, in cases of acute peptic ulcers, initial treatment is carried out symptomatatically, and after 48-72 hours after stabilization of the patient's state, the diagnosis is made on the basis of a radiographic study using barium.

In rare cases, atypical cells of the stomach mucosa, selectively accumulating certain radioactive isotopes are found in the field of mekkel diverticula. This study can be applied in cases of recurrent pain in the stomach of unclear etiology.

Taylor R.B.

Reducing the level of hemoglobin and hematocrit in patients with abdominal pains are possible with intra-abdominal or gastrointestinal bleeding. Fast blood loss, which often occurs with impaired ectopic pregnancy or breaking of the spleen hematoma, can lead to small changes in the level of hemoglobin and hematocrit until the redistribution of fluid comes from outside and intracellular space into the bloodstream. Reducing the level of hemoglobin and hematocrit in such cases occurs after massive infusion therapy, carried out to restore the volume of circulating fluid. The low content of erythrocytes suggests chronic blood loss, which can be observed both with malignant neoplasms of the gastrointestinal tract organs and with benign diseases leading to the occurrence of gastrointestinal bleeding. Abdominal pain may occur with perforation of chronic stomach or duodenal ulcers, as well as tumors of the gastrointestinal tract, which were the cause of chronic blood loss. A triad of symptoms, including grapple-shaped abdominal pains, signs of acute gastrointestinal bleeding and low hemoglobin, arising after injury, with a high degree of probability indicates hemophilia.

Increasing the number of leukocytes in peripheral blood (leukocytosis) is a non-specific sign in patients with sharp abdominal pain. Leukocytosis can be a manifestation of any inflammatory response or infectious disease. In addition, it is often found in pregnant women, in patients taking steroid hormones, as well as after splenectomy. Although most patients with sharp pain in the belly, the total number of leukocytes in peripheral blood increases, often with sharp inflammatory diseases of the abdominal organs, the number of leukocytes can remain normal. Leukopenia may also be an important sign of the development of an infectious process, especially in older people and infants. In patients with severe leukopenia, even if there are not very intense pain in the stomach, as a rule, the forecast is bad. The blood leukocyte formula is often a more informative indicator of a developing infection process than the total number of leukocytes. In most patients with inflammatory diseases of the abdominal organs, which have an abnormal number of leukocytes in peripheral blood, increased the percentage of immature forms and leukocyte predecessors (the so-called leukocyte formula for the left) represented by stick-core leukocytes, myelocytes and metamielocytes. These leukocyte predecessors are released from bone marrow in response to an inflammatory response in the body. As an example of an important value of the leukocytic formula, when examining patients with abdominal pains, it is possible to obtain the fact that the normal number of leukocytes in peripheral blood in combination with the absence of a leukocytaric formula shift to the left is only less than 5% of patients with acute appendicitis.

Urgent studies with abdominal pain

General blood test analysis with abdominal pain

The main causes of abdominal pain in the child

Who is neonatologist and how to recognize a knowledgeable specialist?

Crafts for Easter: the most unexpected ideas for creating shards

Star landing: Potap, Pedan and Gorbunov created children's books

Will the schools be preserved in schools: clarifications from mom

When a child himself begins to turn over

Calendar vaccinations

Pregnancy Calendar

Table Prikorma

What studies need to be done to reveal the reason for the abdominal pain?

Do not delay a visit to the doctor if the baby is alarming you. With abdominal pain, it is important to identify violations as soon as possible, and this can be done only with a careful examination of the doctor and laboratory diagnostics. What tests need to be handed over with abdominal pain?

Biochemical blood test helps to identify many diseases of the digestive channel. For example, with violations of the liver function, the amounts of bilirubin are changed, the level of protein, the activity of some enzymes increases.

For this analysis, experts explore venous blood.

The method of constructing a glycemic curve is widely used to evaluate the intrascretory function of the pancreas.

Blood take an empty stomach from the child's finger, and then twice after the introduction of glucose.

Immunological studies of blood serum are informative, especially with severe liver diseases.

By changes in urine tests, it is also possible to judge the impaired function of the gastrointestinal tract.

The level of urine amylase is important in diagnosis. The increase may indicate pancreatitis, cystic lesions of the pancreas, as well as the diseases of the biliary tract.

The definition of bilirubin in the urine is used as an express method for the differential diagnosis of jaundice. For the same purpose, the definition of urobinogen in the urine is carried out. The appearance of bilirubin (urobilinogen) speaks of the defeat of the liver parenchyma and the violation of the outflow of bile.

Increased level of glucose concentration in the urine can be marked with diabetes mellitus.

Coprological study of intestinal content is required when examining a child with diseases of the digestive system.

Material for research is collected in clean dry dishes immediately before the study.

Already evaluating the color, smell and quantity, the doctor will be able to assume some pathological processes in the digestive system.

General blood analysis

Such an analysis allows you to check the indicators in suspected bleeding, inflammatory processes, infectious or helminthous infection, oncological education.

Material fence produce sterile tools. In adults, the material takes from a nameless finger, and in newborn babies - from a thumb on the leg.

Erythrocytes

To study on the biochemical composition, it is necessary to pass venous blood, and it is strictly on an empty stomach (no earlier than 10 hours after the last meal, drugs and even water).

What tests to pass with abdominal pain

The causes of abdominal pain can be various diseases and conditions. It should also be paid to the localization (location) of pain, their character and intensity.

For example, with pain in the right hypochondrine, first of all, it should be thought of inflammation of the gallbladder (cholecystitis), dyskinesia of boring-withdrawing pathways (JVP), bile-stone disease (HCB), inflammatory liver diseases (hepatitis). This area can irradiate pain in pyelonephritis, urolithiasis, pancreatitis.

With pain in the left hypochondrium, inflammation of the pancreas (pancreatitis), splenomegaly (increasing spleen, for example, with various types of anemia), stones and inflammation in the left kidney can also be found, intercostal neuralgia can also be detected.

Pain in the top of the abdomen in the center (in epigastrics) give gastritis, ulcerative ulcer of the stomach, reflux esophagitis (for him is still characteristic of the sternum), inflammation of the head of the pancreas. For the latter, there are more characteristic pains in the upper half of the abdomen.

You come to the doctor, he sends the analysis to the analysis, and you slap on the table and cling to it, requiring a diagnosis.

But the standard is always sent primarily on the blood test and on the feast analysis.

Depending on the nature of the pain, it may be a feces analysis on: dysbacteriosis, enterobiosis, eggs, biochemistry, carbohydrates.

Blood test for sugar, biochemistry, general analysis.

Do not guess in advance, it all depends on you and the mood and middle score in the diploma of the doctor.

The only thing I can advise when you are asked to pass the test for sugar in the blood, hand over a glycated hemoglobin - this analysis is more accurate and more modern.

Erythrocytes

Common protein

How to treat abdominal pain

With appendicitis, inflammation, infections, kidney problems and other serious illnesses of the child can put in the hospital to pass the course of treatment. It will depend on the diagnosis.

Medication drugs

With a strong diarrhea, the child is given saline solutions: regiders, glucosane, tour, oralitis, enterodez, citrotrushosolyan, glucose.
At temperatures - paracetamol in the form of candles (for the smallest) or suspension (for older children).
In case of food poisoning - sorbents: smecta, polyfepan, polysorb, activated carbon, neosmectin, enterosgel.
With dysbacteriosis - preparations for the restoration of intestinal microflora: acipol, bifiform, colibacterin, lines, bificol, bifilin, enterol, lactobacterin, bifidumbacterin, bacteorophages and probiotics.
In case of intestinal infections, antibiotics are prescribed: Ercephuril, Neversman, Furazolidone, gentamicin, kanamycin, nergam, rifampicin, thienams, sulfate anamicine, measurement, ciprofloxacin, ceftazidim.
Enzyme therapy: Digestal, Fxial, Pancurren, Abomin-Pepsin, Panzinorm, Pankreatin, Mezim, Creon.
In food allergies: antihistamines.
Safety spasmodics for anesthesis: papaverin, spasmodomomen, drootserin.

Folk remedies

Abdominal pain - first aid rules

When the abdominal pain appears, you need to put a child on your back, if there is a vomiting, you need to turn the head to turn your head, to adjust your legs in your knees, slowly clockwise stroke the belly - such a posture will help remove spasm, reduce the manifestation of pain.

What to do if the child has a stomach ache

Visit the doctor, pass the overall analysis of blood and urine, feces, do ultrasound, MRI, antimes of the abdominal organs. Colonoscopy, irrigoscopy, FGS - Mandatory diagnostic methods for suspected tractology of the gastrointestinal tract.
Paracetamol-based an anesthetizing agent based on paracetamol, ibuprofen, well-helped antispasmodics (DROTAVERIN). But resort to drugs only in extreme cases, the medications are lubricated by a clinical picture, the doctor will be difficult to quickly determine the diagnosis.
With severe vomiting, diarrhea, high temperature, the main task of parents is to avoid dehydration. Child a child every 5 minutes in small portions, even through force, it is better to use a regiment, oralitis, ordinary water without gas.

What can not be done in abdominal pain

Do not rush to apply heat. If the unpleasant sensations are caused by an attack of appendicitis, other infectious pathologies, then any warming procedures will deteriorate only the situation, cold compresses can also be installed without prior diagnosis.

It is forbidden to do washing, try to feed the baby. With diarrhea and vomit, it is not necessary to immediately give drugs to eliminate these symptoms - so the body is trying to cleanse the toxins.

Before the child examines the doctor, in any case you need to somehow help. Eliminating his condition and avoid unwanted consequences will help the following measures.

What if the newborn has a tedious tummy:

Take hands.
Put your palm on the stomach, stroke it towards a clockwise direction.
Wear a kid on hands in a vertical condition (column) so that he can bother.
When colic - put a newborn on the back, bend the legs in the knees, press them with the tummy (slightly) and straighten, so do several times.
Give dill water.
When swolling - use a gas feed tube, but not to get involved in it.
When constillation, put the enema.

How to eat right

With abdominal pain you need to reconsider the power mode, make a correct and balanced diet for the child.

What can and can not be given in abdominal pain

Did you like the article? Share it

Print article