Bma Illustrated Medical Dictionary

A

abdomenThe region of the body be-

tween the chest and the pelvis. The

abdominal cavity is bounded by the ribs

and diaphragm above, and by the pelvis

below, with the spine and abdominal

muscles forming the back, side, and

front walls. It contains the liver, stom-

ach, intestines, spleen, pancreas, and

kidneys. In the lower abdomen, enclosed

by the pelvis, are the bladder, rectum,

and, in women, the uterus and ovaries.

abdomen, acutePersistent, severe ab-

dominal pain of sudden onset, usually

associated with spasm of the abdomi-

nal muscles, vomiting, and fever.

The most common cause of an acute

abdomen is peritonitis. Other causes

include appendicitis, abdominal injury,

perforation of an internal organ due to

disorders such as peptic ulceror diver-

ticular disease. Acute abdominal pain

commonly begins as a vague pain in the

centre but then becomes localized.

An acute abdomen requires urgent

medical investigation that may involve

a laparoscopyor a laparotomy. Treat-

ment depends on the underlying cause.

abdominal painDiscomfort in the ab-

domen. Mild abdominal pain is common

and is often due to excessive alcohol

intake, eating unwisely, or an attack of

diarrhoea. Pain in the lower abdomen

is common during menstruation but is

occasionally due to a gynaecological

disorder such as endometriosis. Cystitis

is a common cause of pain or discom-

fort in the abdomen. Bladder distension

as a result of urinary obstruction may

also cause abdominal pain.

Abdominal colic is pain that occurs

every few minutes as one of the internal

organs goes into muscular spasm in an

attempt to overcome an obstruction

such as a stone or an area of inflamma-

tion. The attacks of colic may become

more severe and may be associated

with vomiting (see abdomen,acute).

Peptic ulceroften produces recurrent

gnawing pain. Other possible causes of

abdominal pain are infection, such as

pyelonephritis,and ischaemia(lack of

blood supply), as occurs when a volvu-

lus(twisting of the intestine) obstructs

blood vessels. Tumours affecting an

abdominal organ can cause pain. Abdo-

minal pain can also result from anxiety.

For mild pain, a wrapped hot-water

bottle is often effective. Pain due to

peptic ulcer can be temporarily relieved

by food or by taking antacid drugs.

Abdominal pain that is not relieved by

vomiting, persists for more than 6 hours,

or is associated with sweating or faint-

ing requires urgent medical attention.

Urgent attention is also necessary if

pain is accompanied by persistent vom-

iting, vomiting of blood, or passing of

bloodstained or black faeces. Unex-

plained weight loss or changes in bowel

habits should always be investigated.

Investigation of abdominal pain may

include the use of imaging tests such as

ultrasound scanning, and endoscopic

examination in the form of gastroscopy,

colonoscopy, or laparoscopy.

abdominal swellingEnlargement of

the abdomen. Abdominal swelling is a

natural result of obesityand growth of

the uterus during pregnancy. Wind in the

stomach or intestine may cause uncom-

fortable, bloating distension of the

abdomen. Some women experience ab-

dominal distension due to temporary

water retention just before menstrua-

tion. Other causes may be more serious.

ABDOMEN ABDOMINAL SWELLING

A

Stomach

Area of

abdomen

Liver

Large

intestine

ABDOMEN

Small

intestine

Rectum