The intraabdominal process causing severe pain, often requiring surgical intervention.

Causes :

Obstruction stones :
  • ureteric calculi
  • Biliary colic
  • Intestinal obstruction.
Infection or inflammation :
  • Appendicitis
  • Pancreatitis
  • Cholecystitis
Vascular disturbance ;
  • Aneurysm
  • Vessel occlusion
  • Sickle cell anaemia
Perforation rupture :
  • Peptic ulcer
  • Ovarian cyst
  • Ectopic pregnancy
Extraintestinal ;
Cardiovascular

  • Acute myocardial infarction
  • Congestive cardiac failure

Retroperitoneal

  • Abscess
  • Lymphadenopathy
  • Aortic aneurysm

Psychiatric

  • Anxiety
  • Depression

Locomotor

  • Abdominal pain
  • Vertebral compression

Metabolic

  • DKA
  • Hypercalcemia

Drugs or toxins

  •  Steroids
  • NSAIDs
  • Alcohol
  • Lead poisoning
  • Snakebite

Haematological

  • Hemolytic disease
  • Sickle cell anaemia

Neurological

  • Spinal cord lesions
  • Radiculopathy

Pulmonary

  • Pulmonary embolism
  • Pneumonia
Investigations

  • CBC in inflammatory conditions
  • Serum amylase and lipase elevated in pancreatitis
  • X-ray erect abdomen
  • USG/ CT abdomen.
Management
Colicky pain

  • Inj hyoscin 20 mg IV suspension 7.5 mg( buscopan)
  • Inj dicyclomine 20 mg IV or 10 mg PO TID ( cyclopam)
  • Peritonitis and other inflammation - antibiotics( for gram negative and anaerobic bacteria) gentamicin, cefotaxime, ceftriaxone, piperacillin tezobactum
  • perforation- surgical closure
  • Obstruction - should be surgically removed