Lower abdominal pain syndrome

From WikiLectures

The lower abdominal syndrome can be divided:

The pain in the lower left abdomen can have several causes. It depends on the body structures that project into this area.

1. Left-sided renal colic[edit | edit source]

Renal colic

2. Bowel obstruction, ileus[edit | edit source]

  • Often caused by rectosigma cancer, which is found in elderly patients with a long history of digestive problems (constipation, alternation of constipation with diarrhea, enterorrhea).
  • Clinical picture: sudden pain in the left lower abdomen with bloating, lack of flatulence and bowel movement, vomiting missing or late, palpable tumor may be present
  • Dg.: X-ray native standing (ileose image), event. short colonoscopy after barium enema.

3. Ulcerative colitis[edit | edit source]

  • The disease is often known from a personal history, also IBD(Inflammatory Bowel Disease) in the family history.
  • Pain occurs during exacerbation of inflammation and perforation of ulcers (with subsequent limited or diffuse peritonitis).
  • Clinical picture: acute pain in the left lower abdomen with diarrhea with blood and mucus

4. Diverticular Disease (diverticulitis)[edit | edit source]

  • Clinical picture:
    • Typical are colic-like pains in the left lower abdomen, caused by spasms of the colon muscle or actual obstruction, or perforation of an inflamed diverticulum with peritonitis.
    • There are bloody diarrhea with mucus, fever and high CRP. Diagnosis: colonoscopy, but up to 6-8 weeks after inflammation has subsided.
  • Therapy:
    • uncomplicated diverticulitis is treated with a diet (residue-free diet), i.v. administration of antibiotics (e.g. Amoxiclav i.v. + Entizol supp.)
    • complications are solved surgically (diverticulum perforation, ileus)

5. Other causes[edit | edit source]

  • Left-sided appendicitis
  • Adnexitis
  • Ectopic pregnancy


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Kategorie:Chirurgie Kategorie:Gastroenterologie Kategorie:Vnitřní lékařství