Abdominal pain can be caused by various ailments. Disease processes in the chest and the pelvis can mimic abdominal pain. There are several characteristics of abdominal pain, which can let a patient know that it is serious enough to seek emergency care. Abdominal pain can be acute or chronic. The onset nature and character of the pain can help determine whether a serious disease is causing pain.
Let’s take several common surgical emergencies. We will consider appendicitis, and cholecystitis. These are all common causes of abdominal pain that require urgent surgical consultation. This consultation can be by a surgeon in an office setting or in an emergency department setting. The most important concept to understand is that abdominal pain that does not improve within a fairly short period of time is most likely a serious condition.
Appendicitis is caused by blockage of the appendix, which is in the right lower portion of the abdomen. This blockage causes inflammation and swelling followed by infection and eventually gangrene of the appendix. The only treatment for appendicitis is surgical removal of the appendix. Clinical symptoms of appendicitis can vary widely, but the most common symptom is localized right lower quadrant abdominal pain. The appendix can rupture within 24 hours of onset of symptoms. Commonly associated symptoms are nausea fever, and vomiting. The onset of the type of pain in appendicitis precedes nausea. The pain in appendicitis is worse with movement. Patients with appendicitis do not usually have diarrhea or profuse vomiting. Pain in the right lower portion than does not resolve within a short period of time should be treated as appendicitis until proven otherwise. Surgical consultation is necessary to prevent rupture of the appendix and septic shock.
Cholecystitis is inflammation and or infection of the gallbladder the most common cause of cholecystitis is close diocese or stones in the gallbladder. The stones can block the gallbladder and again cause inflammation or swelling and eventually infection of the gallbladder. Surgical consultation for laparoscopic cholecystectomy is necessary. Pain with cholecystitis is usually in the right upper portion the abdomen. This pain is associated most commonly with nausea and pain may radiate to the back. Fever, dark urine, or light colored stool, are an indication of a more severe infection of the biliary tract.
Surgical consultation for these two diseases is essential. Historically, removal of the gallbladder and removal of the appendix were both done by open surgical procedure. Now with advances in microscopic surgical techniques, these two surgical emergencies can be addressed with laparoscopic surgery. Laparoscopic appendectomy and laparoscopic cholecystectomy are to the most commonly performed surgical procedures. These procedures allow for smaller incisions, less use of narcotic pain medication, and quicker discharge from the hospital. Minimally invasive training techniques are essential to ensure that your surgeon is qualified to perform these procedures.
Again, the most important concept in deciding to seek medical attention in abdominal pain is the unremitting nature of the pain. If abdominal pain persists for more than six to eight hours, gets progressively worse, or is associated with high fever, emergency medical care should be sought. Only prompt diagnosis and recognition of these common surgical emergencies will prevent complications.
