(abdominal dehiscence) spontaneous opening of a surgical wound after an abdominal operation.
Contents The principal contents of the abdominal cavity are the digestive organs, i.e. the stomach and INTESTINE, and the associated glands, the LIVER and PANCREAS. The position
of the stomach is above and to the left when the individual is lying down, but may be much lower when standing. The liver lies above and to the right, largely under cover of the ribs, and occupying the hollow of the diaphragm. The two KIDNEYS lie against the back wall on either side, protected by the last two ribs. From the kidneys run the URETERS, or urinary ducts, down along the back wall to the URINARY BLADDER in the pelvis. The pancreas lies across the spine between the kidneys, and on the upper end of each kidney is a suprarenal gland
(see ADRENAL GLANDS). The SPLEEN is positioned high up on the left and partly behind the stomach. The great blood vessels and nerves lie on the back wall, and the remainder of the space is taken up by the intestines or bowels (see INTESTINE). The large intestine lies in the ?anks on either side in front of the kidneys, crossing below the stomach from right to left, while the small intestine hangs from the back wall in coils which ?ll up the spaces between the other organs. Hanging down from the stomach in front of the bowels is the OMENTUM, or apron, containing much fat and helping to protect the bowels. In pregnancy the UTERUS, or womb, rises up from the pelvis into the abdomen as it increases in size, lifting the coils of the small intestine above it.
The PELVIS is the part of the abdomen within the bony pelvis (see BONE), and contains the rectum or end part of the intestine, the bladder, and in the male the PROSTATE GLAND; in the female the uterus, OVARIES, and FALLOPIAN TUBES.... abdomen
Before the doctor comes: 3 drops each or any one: Tinctures Arnica, Calendula and Hypericum; hourly. ... abdomen, injuries
Various processes that can occur include in?ammation, ulceration, infection or tumour. Abdominal disease may be of rapid onset, described as acute, or more long-term when it is termed chronic.
An ‘acute abdomen’ is most commonly caused by peritonitis – in?ammation of the membrane that lines the abdomen. If any structure in the abdomen gets in?amed, peritonitis may result. Causes include injury, in?ammation of the Fallopian tubes (SALPINGITIS), and intestinal disorders such as APPENDICITIS, CROHN’S DISEASE, DIVERTICULITIS or a perforated PEPTIC ULCER. Disorders of the GALLBLADDER or URINARY TRACT may also result in acute abdominal pain.
General symptoms of abdominal disease include:
Pain This is usually ill-de?ned but can be very unpleasant, and is termed visceral pain. Pain is initially felt near the mid line of the abdomen. Generally, abdominal pain felt high up in the mid line originates from the stomach and duodenum. Pain that is felt around the umbilicus arises from the small intestine, appendix and ?rst part of the large bowel, and low mid-line pain comes from the rest of the large bowel. If the diseased organ secondarily in?ames or infects the lining of the abdominal wall – the PERITONEUM – peritonitis occurs and the pain becomes more de?ned and quite severe, with local tenderness over the site of the diseased organ itself. Hence the pain of appendicitis begins as a vague mid-line pain, and only later moves over to the right iliac fossa, when the in?amed appendix has caused localised peritonitis. PERFORATION of one of the hollow organs in the abdomen – for example, a ruptured appendix or a gastric or duodenal ulcer (see STOMACH, DISEASES OF) eroding the wall of the gut – usually causes peritonitis with resulting severe pain.
The character of the pain is also important. It may be constant, as occurs in in?ammatory diseases and infections, or colicky (intermittent) as in intestinal obstruction.
Swelling The commonest cause of abdominal swelling in women is pregnancy. In disease, swelling may be due to the accumulation of trapped intestinal contents within the bowel, the presence of free ?uid (ascites) within the abdomen, or enlargement of one or more of the abdominal organs due to benign causes or tumour.
Constipation is the infrequent or incomplete passage of FAECES; sometimes only ?atus can be passed and, rarely, no bowel movements occur (see main entry for CONSTIPATION). It is often associated with abdominal swelling. In intestinal obstruction, the onset of symptoms is usually rapid with complete constipation and severe, colicky pain. In chronic constipation, the symptoms occur more gradually.
Nausea and vomiting may be due to irritation of the stomach, or to intestinal obstruction when it may be particularly foul and persistent. There are also important non-abdominal causes, such as in response to severe pain or motion sickness.
Diarrhoea is most commonly due to simple and self-limiting infection, such as food poisoning, but may also indicate serious disease, especially if it is persistent or contains blood (see main entry for DIARRHOEA).
Jaundice is a yellow discoloration of the skin and eyes, and may be due to disease in the liver or bile ducts (see main entry for JAUNDICE).
Diagnosis and treatment Abdominal diseases are often di?cult to diagnose because of the multiplicity of the organs contained within the abdomen, their inconstant position and the vagueness of some of the symptoms. Correct diagnosis usually requires experience, often supplemented by specialised investigations such as ULTRASOUND. For this reason sufferers should obtain medical advice at an early stage, particularly if the symptoms are severe, persistent, recurrent, or resistant to simple remedies.... abdomen, diseases of
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