Abdomen point tenderness

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at December 14, 2015
StartSymptomsAbdomen point tenderness

Abdominal point tenderness can be a very difficult symptom to link to the correct disorder. Because there are so many major organs overlapping each other located in the abdominal cavity, figuring out which organ is causing the discomfort can be a long process involving multiple tests. When experiencing point tenderness in the abdomen, it is best to be as specific as possible about the location and intensity of the pain to help with a quick diagnosis.

Contents

Definition & Facts

Abdominal point tenderness is a pain that is created when a specific spot on the abdomen is pressed. The area can be sensitive or painful without applying pressure as well, but it will greatly increase when pressure is applied to the spot that the pain is originating from. Typically, the pain in the abdomen is quite isolated, meaning that it does not spread out very far from the point where it is initiating.

The pain is also very intense - leaving the patient with no doubt that there is an issue. Abdominal point tenderness is not associated with gas pains, menstrual cramps, or stomach aches. It usually comes on quickly, becoming very severe sometimes within a matter of hours. It also does not dissipate as time goes by; it only increases in intensity.

Causes

There are many different conditions that can cause abdominal point tenderness. Some of the most common causes include appendicitis, abdominal abscess, certain types of hernias, ovarian torsion (in women), Meckel's diverticulum, and diverticulitis. Appendicitis is an inflammation and/or infection of the appendix, which is a small organ with little known purpose located between the small and large intestines.

An abdominal abscess occurs when a pocket of infections starts to grow on the outer or inner lining of an organ in the abdominal cavity. Hernias occur when a section of the intestines rips through the lining and protrudes outward in a kinked, bulbous knot. Ovarian torsion is a twisting of the ovaries and/or fallopian tubes which is usually caused by an ovarian cyst or tumor. Meckel's diverticulum is a genetic condition where a small pouch forms on the lower end of the large intestine.

It is present at birth, but only a few people develop symptoms and it can be years before it becomes inflamed or infected, causing the point tenderness. Diverticulitis is an acute inflammation of the inner lining of either the small or large intestines, usually brought on by diet or medications. In addition to acute pain, all of these disorders can be accompanied by additional symptoms such as nausea, vomiting, diarrhea, constipation, fainting, fever, loss of appetite, and pale or bloody stool.

When to see a doctor

All disorders causing abdominal point tenderness are always medical emergencies. Anyone experiencing this should seek emergency medical attention as soon as their symptoms escalate to severe. While informing the primary physician afterwards is advised so they can conduct any follow-up treatments, the initial situation should be treated as an emergency.

To diagnose the cause of the problem, the doctor will want a detailed description of where the pain is originating from, as well as your medical history to help isolate any possible genetic causes. They will also press on the patient's abdomen to see first-hand where the worst of the pain is located. The location of the pain is very important because doctors divide the abdomen into four quadrants: The right upper quadrant contains the liver and the gallbladder; the left upper quadrant contains the stomach and the duodenum; the right lower quadrant contains the appendix; and the left lower quadrant contains the sigmoid colon.

Knowing which organ is most likely causing the problem will help the doctor to know what type of tests to run. These tests include a complete blood count, an abdominal X-ray, a CT scan, an abdominal ultrasound, a C-reactive protein test, and a pregnancy test (in women). The results of the tests, combined with the information the doctor receives from the patient regarding the location of the pain, is usually enough to make an accurate diagnosis.

Treatment & Therapy

The type of treatment for abdominal point tenderness depends entirely upon what the doctor identifies to be the cause. In some severe cases, surgery many be required immediately. Appendicitis, a colon obstruction, ovarian torsion, and a hernia will all require surgery to repair, sometime immediately if the situation is severe enough.

Surgery is usually followed up by antibiotics to clear up any infection that has occurred. Some conditions, such as an abdominal abscess and diverticulitis, only require medication to treat, usually antibiotics, anti-inflammatory, anti-nausea, and pain medication prescriptions. Other treatments include intravenous fluids and electrolytes, typically administered with the patient in first hospitalized for dehydration.

If a patient is unable to be diagnosed using standard tests, it may be necessary for the doctor to perform a laparoscopic examination as part of the treatment. This is an exploratory surgery where a scope is inserted into the abdomen to help the doctor to see the source of the pain. However, unlike surgeries to treat a condition, a laparoscopic examination cannot guarantee results because it might not be able to locate the issue. With any disorder causing abdominal point tenderness, additional follow-up visits will be required to make sure the treatment is working.

Prevention & Prophylaxis

Other than maintaining a healthy and fit lifestyle, there are not many actions that can be taken to prevent abdominal point tenderness. For some conditions causing it, such as appendicitis, there are few known causes. However, there can be severe long-term consequences for not treating abdominal pain when it first develops, some of which are life-threatening.

Infected areas can rupture, spreading infected liquids throughout the abdominal cavity. This can lead to additional infection elsewhere as well as internal bleeding. Untreated ovarian torsion can result is pelvic scarring and even infertility. Untreated hernias can increase in size, ripping out of the intestinal lining far enough that it forms an intestinal blockage.

If left untreated, diverticulitis can be fatal. While the individual causes of abdominal point tenderness cannot usually be prevented, the long-term consequences of them can be by simply having them treated.

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