PAIN
Most abdominal pains originate in stretch receptors present in
the wall of hollow organs (intestine, ureter and biliary tract)
or in the capsules of solid organs like liver, spleen and
kidney. Pain in a hollow system is usually colicky with an
accompanying vomitting.
Pain in solid organs is usually of a dull aching nature.
There is a third variety of pain originating from the receptors
present in the inflammed peritoneium.
This pain is very vague, of a general distribution and burning in
nature and on involvement of the parietal peritoneum it becomes
more accurately localised.
2.5 ISCHAEMIA AND PAIN
Thrombosis or embolism of the main blood vessels of the intestine
produce pain of the corresponding portion of the bowel.
This may occur along the distribution of a superior mesentry
artery or inferior mesenteric artery producing a picture of
severe pain of the small or large bowel and a profound shock like
state.
Ischaemia of the bowel can also be produced in cases of
obstructions of the bowel left untreated for long period and in
stragulated hernia
2.6 DIAGNOSIS
With experience and modern imaging techniques (see 3.4) it is
possible to arrive at an early accurate diagnosis and to plan a
surgical intervention in most cases.
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