Understanding pain abdomen: Anatomical considerations

Abstract

Although abdominal pain is common and often inconsequential, acute and severe abdominal pain is almost always a symptom of intrabdominal disease. Ascertaining the cause of abdominal pain is quite like solving a puzzle. Putting together the history, clinical findings and the result of investigations into perspective makes the diagnosis apparent. Textbook descriptions of abdominal pain have limitations because people react to and interpret pain differently. Proper understanding of the anatomy and the embryological origin of the abdominal organs is necessary for a proper understanding of the disease process. Referred pain is one particular diagnostic dilemma. Neuroscientists are still trying to understand which anatomical connections are responsible for referred pain. Referred pain is experienced when nerve fibres from regions of high sensory input (such as skin) and nerve fibres from regions of low sensory input (such as the viscera) happen to converge on the same or adjacent levels of the spinal cord. Referred pain can be both somatic and visceral and has to be interpreted judiciously while attempting to reach a diagnosis. This article attempts to understand the anatomical and neurological relationships of the intrabdominal organs and its relevance in various causes of acute abdominal pain.

Keywords

• acute abdominal pain
• embryology
• neurological causes
• referred pain