I
ABDUCENT NERVE
TREATMENT
For mild abdominal pain, self-treatment
measures, such as a wrapped hot-water
bottle or a milky drink, are often effec-
tive. Pain due to peptic ulcer can be
temporarily
relieved
by
consuming
food or by taking
antacid drugs.
Abdominal pain that is not relieved
by vomiting, persists for more than six
hours, or is associated with sweating or
fainting requires urgent medical atten-
tion. Urgent attention is also necessary
if pain is accompanied by persistent
vomiting, vomiting of blood, or passing
of bloodstained or black faeces. Abdom-
inal
pain
that
is
accompanied
by
unexplained weight loss or changes in
bowel habits should always be investi-
gated by a doctor.
INVESTIGATION AND DIAGNOSIS
The
doctor
makes
a
diagnosis
of
abdominal pain based on a physical
examination and a detailed description
of the patient’s symptoms. Investigation
of severe abdominal pain may also
include
blood tests,
imaging tests such as
ultrasound
scanning,
and
endoscopy
(examination of a body cavity using a
flexible viewing tube) in the form of
laparoscopy
(viewing the abdominal cav-
ity),
gastroscopy
(viewing the stomach
and duodenum), or
colonoscopy
(view-
ing the large intestine).
abdominal swelling
Enlargement of the abdomen, which
may be due to a variety of causes.
Abdominal swelling is a natural result
of
obesity
and enlargement of the uterus
during pregnancy.
Some causes of abdominal swelling
are harmless. Wind in the stomach or
intestine
may
cause
uncomfortable,
bloating
distension.
Distension
as
a
result of temporary water retention may
occur in some women just before
men-
struation.
Other causes may be more
serious. For instance,
ascites
(fluid accu-
mulation in the abdominal cavity) may
be a symptom of cancer or disease of
the heart, kidneys, or liver; swelling
may also be due to intestinal obstruc-
tion (see
intestine
,
obstruction of
) or an
ovarian cyst.
INVESTIGATION
Diagnosis of the underlying cause may
involve X-rays
(see
abdominal X-ray),
ultrasound scanning, laparotomy
(surgical
exploration of the abdomen) or
laparos-
copy
(examination of the inside of the
abdomen using a rigid or flexible view-
ing tube). In ascites, some of the fluid
in the abdomen may be drained for
detailed examination.
abdominal thrust
A first-aid treatment for choking in
which
a
sharp
upward
pressure
is
applied to the upper abdomen, just
below the rib cage, to dislodge a for-
eign body that is obstructing the airway.
The technique is also known as the
Heimlich manoeuvre.
abdominal X-ray
An
X-ray
examination of the abdominal
contents. An abdominal X-ray is often
one of the first steps in the investigation
of acute abdominal disease.
X-rays do not reveal the internal
structure of organs, but they do show
their
outlines.
X-rays
can
therefore
show whether any organ is enlarged
and can detect swallowed foreign bod-
ies in the digestive tract. X-rays also
show accumulations of fluid and gas:
distended loops of bowel containing
collections of fluid often indicate the
presence
of
an
obstruction
(see
intestine, obstruction of);
gas outside the
intestine indicates intestinal
perforation.
Calcium, which is opaque to X-rays,
is present in most kidney stones (see
calculus
,
urinary tract
)
and
in
some
gallstones
and aortic
aneurysms;
these
can
sometimes
be
detected
on
an
abdominal X-ray.
Abdominal X-rays may need to be
followed by procedures that provide
more information, such as
ultrasound
scanning
,
barium X-ray examinations
(use
of a contrast medium to detect dis-
orders
of the
gastrointestinal tract),
laparoscopy
(internal examination of the
abdomen using a viewing instrument),
CT scanning
or
MRI
(techniques that
produce cross-sectional or three-dimen-
sional images of body structures).
abducent nerve
The sixth
cranial nerve.
The abducent
nerve supplies the lateral rectus muscle
of each eye, which is responsible for
moving the eyeball outwards. The abdu-
cent nerve originates in the pons (part
of the
brainstem
) and passes along the
DIAGNOSING ABDOMINAL PAIN
The doctor conducts a physical examination and listens to the patient’s description
ofthe pain. More investigations, such as blood tests, X-rays, or imaging tests
(including ultrasound scanning), may be carried out. Ifthe diagnosis is still in
doubt, endoscopic inspection ofthe stomach and duodenum (gastroscopy), large
intestine (colonoscopy), or abdominal cavity (laparoscopy) may be performed.
Oesophageal reflux
A burning pain in
the chestthat is
accompanied by
regurgitation of
stomach acid and
is often worse after
meals or when lying
down at night.
Gallbladder pain
A cramplike or steady
pain under the right
ribs that is often
accompanied by
vomiting and fever.
Duodenal ulcer pain
This pain often occurs in
the same small area and
maybe temporarily
relieved byeating or
taking antacids.
Appendicitis pain
This pain starts around
the navel before finally
settling in the lower right
side ofthe abdomen.
Wind
Excess wind in the
digestive system affects
a large area of the
abdomen and can
cause an uncomfortable,
distended feeling.
Pelvic organ
inflammation
A constant diffuse pain,
usuallyaccompanied by
vaginal discharge or
fever, that extends over
the lower abdomen.
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