Abdominal Pain

Abdominal pain is a nonspecific symptom that may be associated with many conditions. Some do not occur within the abdomen itself, but cause abdominal discomfort. An example would be the abdominal pain associated with strep throat. Some originate within the abdomen, but are not related to the gastrointestinal tract, such as a dissecting aortic aneurysm.

The severity of the pain does not always reflect the severity of the condition causing the pain. Severe abdominal pain can be associated with mild conditions, such as gas or the cramping of viral gastroenteritis, while relatively mild pain (or no pain) may be present with severe and life-threatening conditions, such as cancer of the colon or early appendicitis.

Abdominal pain can be caused by toxins, infection, liver disease, renal disease, bladder infections, ulcers, perforation, pancreatic disease, trauma, and metabolic diseases. The list is so extensive that it would be impossible to name all the possible diseases in each of the above groups.

Because abdominal pain is nonspecific, the doctor will require much more information regarding the time of onset, duration of pain (minutes, hours, days, or even months), location of pain, nature of pain (dull, sharp, steady, off and on), severity of pain, and relationship to normal functions,

The location of pain and its time pattern may be helpful in suggesting its cause. During physical examination, the doctor will try to determine if the pain is localized to a single area (point tenderness) or diffuse, and if the pain is related to inflammation of the peritoneum or of the abdomen. If the doctor finds evidence of peritoneal inflammation, the abdominal pain may be classified as an “acute abdomen”, which often requires prompt surgical intervention.

In addition the doctor will try to relate the abdominal tenderness to other general symptoms, such as fever, fatigue, general ill feeling (malaise), nausea, and vomiting. Then the doctor will ask about increasingly specific symptoms as the diagnostic considerations are narrowed.

II. Class Assignment. (Revision)

1. a) Give the words of the close meaning:

to affect, to cause, to decrease, acute, slight, damage, to rise, to perforate, to spread, to enlarge, permanent

b) Give the words of the opposite meaning:

onset, gradually, fat, exertion, to precede, internal, malignant, moist, frequent, to improve, to result in

2. Supply one of known to you words of the same root. Make up sentences using them:

appear, tender, danger, occur, digest, bleed

3. Explain the following terms:

hypothermia, fibrillation, leucocytosis, a causative agent, anaemia, malaise, pathogenesis, aetiology

4. Translate the sentences:

1) The surgeon did not doubt that he could perform this operation under local anaesthesia.

2) Gangrenous forms of appendicitis are dangerous to life because they may result in peritonitis.

3) The retention of stool may be due to the inflammatory process in the appendix.

4) During the operation the upper lobe of the lung was removed since a malignant tumour had been controlled the patient complained of a moderate tenderness on palpation.

5. 1) Read and translate the text “Acute Appendicitis”. 2) Put questions to the text. 3) Retell it: