irregular on palpation. There may be a single or multiple nodules.
Left Hypochondrial Pain
Acute Pancreatitis
The onset of this disease is sudden with severe pain in the left hypochondrium extending to the
epigastrium. The pain may also radiate to the left scapula. There may be nausea and vomiting
and the patient looks very ill and pale as if suffering from shock.
Chronic Pancreatitis
Chronic pancreatitis is more common in men over 50. The pain is in the left hypochondrium and
may radiate to the epigastrium. Interestingly, the pain may also occur in the right
hypochondrium (suggesting involvement of the Liver channel from a Chinese point of view).
The pain is relieved by crouching forward or lying prone. This is a very typical sign of chronic
pancreatitis.
"Abdominal pain" indicates pain in any part of the abdomen below or just around the umbilicus
(Figure 16.1(385)).
In this chapter I shall discuss abdominal pain which is intestinal in origin, not abdominal pain
from gynaecological or other conditions. In women, it is not always easy to distinguish whether
abdominal pain is of intestinal or gynaecological origin, also because the two conditions may
well overlap.
Generally speaking, an abdominal pain which is clearly related to food intake or bowel
movements and is associated with either constipation or diarrhoea, is purely of intestinal origin.
An abdominal pain which is clearly related to the menstrual cycle, and is associated with
irregular periods, dysmenorrhoea or mid-cycle pain, is of gynaecological origin.