Abdominal syndrome

Abdominal syndrome, often referred to as "acute abdomen", is an urgent pathological condition, the leading symptom of which is abdominal pain caused by pathology of the internal organs of the abdominal cavity, caused by complications, pathology of the abdominal cavity itself, or abdominal trauma.

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Causes abdominal syndrome

Diseases that cause the development of such a condition as abdominal syndrome can be conditionally divided into 2 types: functional, arising as a result of spasm of the smooth muscles of organs or excretory ducts, defined as colic; organic, developing with inflammation, strangulated hernias, obstruction, perforation of hollow organs, rupture of parenchymatous organs.

Spastic pains (colic) can be caused by a neuro-reflexive pathway or occur when passing stones that can become trapped in the duct, causing complications with the transition to organic pathology, for example, a stone trapped in the bile duct will lead to the development of jaundice, and inflammation can also join in. Their distinctive feature is a cramping nature, relieved within 1-2 hours by prescribing antispasmodics, the absence of palpation symptoms of peritoneal irritation (tension of the abdominal wall, Shchetkin-Blumberg symptom). If you are sure that there is no peritonitis, sedatives and analgesics can be added to antispasmodics to relieve colic. Of the organic pathologies, only acute intestinal obstruction causes cramping pain, but its clinical picture is very different from colic: dehydration, vomiting that does not bring relief, gaping of the rectal ampulla during rectal examination (Obukhov Hospital symptom), etc.

Determination of the affected organ or system depends on the localization of pain; since each organ is reflexively projected onto the abdominal wall, and its irradiation. The nature is determined by a detailed local examination with the identification of specific symptoms, laboratory tests, preferably in dynamics, and the necessary instrumental studies according to indications to confirm the diagnosis established by anamnesis and physical examination.

In the vast majority of cases, abdominal syndrome is caused by diseases of the abdominal organs, but pseudo-abdominal syndrome can also form, when, due to reflex connections, radiating pain in the abdomen can be caused by diseases of other organs.

Pseudo-abdominal syndrome can develop in case of heart pathology, especially myocardial infarction, angina pectoris, in case of pleural cavity pathology - exudative and purulent pleurisy, lower lobe pneumonia; in case of urological diseases - urolithiasis, pyelonephritis, acute urinary retention, paranephritis; in case of diseases and injuries of the central and peripheral nervous system - meningitis, tumors, brain and spinal cord injuries, radiculitis, neuralgia; infectious diseases - flu, measles, scarlet fever, shingles, food poisoning, a number of other diseases - diabetes, rheumatism, chronic lead intoxication, endometriosis, etc. In children, pseudo-abdominal syndrome is caused by sore throats and tonsillitis, otitis (Brenneman's disease - often occurs as cholecystitis), meningitis, osteomyelitis.

Symptoms abdominal syndrome

Symptoms of abdominal syndrome can vary depending on its form and the underlying cause. However, there are a number of typical symptoms that may be observed with this condition. Here are some of them:

1. Pain or discomfort: Pain may be sharp, dull, stabbing, or burning. Its intensity may also vary from moderate to severe.
2. Nausea and vomiting: These symptoms may accompany abdominal pain and can be caused by a variety of reasons, including acute or chronic gastritis, peptic ulcers, infections, and others.
3. Changes in bowel movements: This may include diarrhea, constipation, or unusual bowel movements. Changes in bowel movement frequency and consistency may indicate a problem with the gastrointestinal tract.
4. Well-being: Patients with abdominal syndrome may experience general malaise, weakness, loss of appetite and weight.
5. Abdominal distension: The abdomen may be distended and painful to the touch. This symptom may be characteristic of some gastrointestinal diseases.
6. Fever: In case of infectious abdominal syndrome, an increase in body temperature may be observed.
7. Symptoms of organ-specific forms: Depending on the affected organ, there may be characteristic symptoms associated with this organ. For example, jaundice with liver damage or pain in the gallbladder area with cholecystitis.

Forms

There are many forms of abdominal syndrome, each of which may be associated with different causes and have characteristic signs. Some of the forms include:

1. Acute pain syndrome:

   • Characterized by sudden, acute abdominal pain.
   • It can be caused by various reasons, such as acute inflammation of the abdominal organs, peritonitis, acute appendicitis, cholelithiasis and others.
   • Requires urgent medical attention and often surgery.

2. Chronic pain syndrome:

   • Characterized by prolonged or intermittent abdominal pain that can last for months or even years.
   • Causes may include chronic gastrointestinal diseases, inflammatory processes, cancer, etc.

3. Dyspeptic syndrome:

   • Includes symptoms such as nausea, vomiting, pain or discomfort in the upper abdomen after eating.
   • May be associated with various causes, including gastritis, peptic ulcer, reflux esophagitis, etc.

4. Infectious syndrome:

   • Characterized by symptoms of abdominal infection such as fever, nausea, vomiting, diarrhea, etc.
   • May be caused by infection of the abdominal cavity or adjacent organs.

5. Organ-specific syndrome:

   • Associated with damage to a specific organ in the abdominal cavity, such as the liver (hepatic syndrome), gallbladder (cholecystitis), spleen (splenic syndrome), and others.

6. Irritable Bowel Syndrome (IBS):

   • Characterized by pain, discomfort and changes in bowel function such as diarrhea and constipation.
   • Can be caused by stress factors, diet and others.

Each form of abdominal syndrome requires an individual approach to diagnosis and treatment depending on its cause. Reliable establishment of the form of the syndrome and identification of the underlying disease are key steps in effective therapy.

Complications and consequences

Complications can be serious and potentially life-threatening. Here are some of the possible complications of abdominal syndrome:

1. Peritonitis: This is an inflammation of the peritoneal lining of the abdomen that can develop as a complication of a ruptured organ, ulcer, appendicitis, or other gastrointestinal problems. Peritonitis requires immediate medical attention.
2. Infections: Abdominal infections can result from a variety of conditions, such as acute appendicitis or perforation of the gastrointestinal tract. They can lead to sepsis, which is potentially fatal.
3. Organ Folding: Sometimes, due to inflammation and tumors, organs can fold or move within the abdominal cavity, which can cause compression and lack of blood supply.
4. Abscess formation: When infection or inflammation occurs, abscesses, or pockets of pus, may form. They require drainage and antibiotics.
5. Organ damage: Acute illness or injury can damage abdominal organs such as the liver, spleen, kidneys, which may require surgery.
6. Long-term illness: If abdominal syndrome is caused by chronic diseases such as chronic gastritis or chronic cholecystitis, complications may include worsening of the condition, exacerbations, and development of other chronic problems.
7. Loss of life: If abdominal syndrome is not treated properly or is delayed, complications may arise that may lead to the death of the patient.

Diagnostics abdominal syndrome

Diagnosis of abdominal syndrome requires a comprehensive approach, including anamnesis, physical examination, laboratory and instrumental studies. Here are the main methods for diagnosing abdominal syndrome:

1. Anamnesis (Medical History):

   • The doctor talks to the patient to find out the nature of the pain, its onset, duration, intensity, localization and other symptoms.
   • It is important to know about previous illnesses, surgeries, chronic diseases and medications.

2. Physical examination:

   • The doctor examines and palpates the patient's abdomen, determining the presence of painful areas, their location and nature. This can help identify signs of peritoneal inflammation or other pathologies.
   • The patient's general condition is checked, including body temperature, blood pressure, pulse, and respiratory rate.

3. Laboratory tests:

   • Blood and urine are analyzed for inflammatory markers, infections, and other pathologies.
   • The study of biochemical parameters can help to identify disorders of the liver, pancreas and other organs.

4. Instrumental studies:

   • An ultrasound of the abdominal cavity allows you to visualize internal organs and identify changes in their structure.
   • CT (computed tomography) and MRI (magnetic resonance imaging) provide more detailed images of internal organs and tissues.
   • Endoscopic tests such as esophagogastroduodenoscopy (EGD) and colonoscopy may be used to evaluate the digestive tract.

5. Radiography: X-rays can be used to detect abnormalities inside the abdomen.

6. Additional tests: In some cases, additional specialized tests, such as laparoscopy or tissue biopsy, may be needed.

Diagnosis requires collaboration between the doctor and the patient to obtain a complete picture of the disease. Accurate and timely identification of the cause of symptoms allows for effective treatment and a better prognosis.

Differential diagnosis

In terms of differential diagnostics: they are accompanied by abdominal pain, vomiting, intestinal paresis, or hyperperistalsis, dry tongue, tachycardia or bradycardia, but there are no palpation symptoms of peritoneal irritation (tension of the anterior abdominal wall and Shchetkin-Blumberg symptom). With a high-quality anamnesis with a complete physical examination and additional instrumental studies, the underlying pathology that causes pseudo-abdominal syndrome is always revealed.

Treatment abdominal syndrome

In all cases of diseases that provoke abdominal syndrome, if there are no obvious signs of another pathology (myocardial infarction, gynecological, infectious, pulmonary pathology, etc.), the patient must be taken to a surgical hospital by emergency care.

Treatment for abdominal syndrome depends on its cause and severity. It is important to remember that abdominal syndrome can be a consequence of various medical conditions, so it is necessary to consult a doctor for an accurate diagnosis and development of an appropriate treatment plan. Here are some general approaches to treating abdominal syndrome:

1. Treating the underlying condition: The doctor must determine the cause of the abdominal syndrome and treat the underlying condition. For example, if the cause is an infection, the patient may be prescribed antibiotics. If the abdominal syndrome is caused by a gastrointestinal disease, antisecretory therapy or surgery may be required.
2. Painkillers: Your doctor may recommend analgesics or anti-inflammatory drugs to help relieve pain. However, it is important to follow your doctor's instructions and not overuse these medications.
3. Diet: In some cases, changing your diet can help reduce symptoms of abdominal syndrome. For example, with irritable bowel syndrome, you may need to eliminate certain foods from your diet that trigger flare-ups.
4. Avoiding stress: Stress can worsen symptoms of abdominal syndrome. Relaxation techniques and psychological support can help manage stress.
5. Physical activity: Your doctor may recommend certain exercises or physical therapy to strengthen your abdominal muscles and improve the function of your abdominal organs.
6. Surgical treatment: In some cases, especially if there are complications, surgery may be required. For example, in cases of appendicitis or perforation of the gastrointestinal tract.
7. Treatment of symptoms: Medications may be prescribed to relieve symptoms such as nausea, vomiting, or diarrhea.

It is important to emphasize that treatment of abdominal syndrome should be individualized and prescribed by a doctor based on diagnosis and assessment of the patient's condition. Self-medication can be dangerous, so you should always contact a medical specialist if abdominal symptoms appear.

Forecast

The prognosis for abdominal syndrome depends on its cause and severity. In most cases, abdominal syndrome can be treated successfully and has a good prognosis, especially if the cause is identified and treated early. However, the prognosis can vary significantly depending on the specific condition.

For example, if abdominal syndrome is caused by acute appendicitis and the patient receives prompt surgical treatment, the prognosis is usually favorable and most patients recover fully. However, if treatment is delayed or complications or infections occur, the prognosis may be less favorable.

In chronic conditions such as irritable bowel syndrome or chronic gastropathy, the prognosis can be long and depends on the effectiveness of treatment and the patient's ability to manage symptoms over time.

If the abdominal syndrome is caused by a serious condition such as peritonitis (inflammation of the abdominal cavity) or acute mesenteric ischemic syndrome (impaired blood supply to the intestines), the prognosis can be serious and depends on the speed of diagnosis and initiation of treatment. These conditions require immediate medical attention.

It is important to note that the prognosis for abdominal syndrome is individual and depends on many factors, including the cause, severity, age, and overall health of the patient. Patients should consult a doctor for an accurate diagnosis and treatment plan to improve the prognosis and avoid complications.