Abdominal Pain – possible causes and
First Aid
Martina Klincová
Learning objectives
Student will learn the
possible most
common causes of
abdominal pain and
some typical
symptoms.
1
Student will learn the
basic procedure of
first aid for abdominal
pain.
2
Student will learn in
which case he or she
should call 112 for a
person with
abdominal pain.
3
Basic abdominal anatomy
̶ RUQ = right upper quadrant
̶ LUQ = left upper quadrant
̶ RLQ = right lower quadrant
̶ LLQ = left lower quadrant
̶ Epigastrium = upper medial
part of abdomen below costal
arch
̶ Umbilical medial part
Gallstone Colic
Duodenal Ulcer
Constipation
Renal Colic
Strangulated hernia
Ectopic pregnancy,
ruptured ovarian
cyst, ovarian torsion
Appendicitis
Renal Colic
Strangulated hernia
Ectopic pregnancy,
ruptured ovarian
cyst, ovarian torsion
Gastric Ulcer
Ruptured Spleen
Ileus
Pancreatitis
Abdominal Aortic
Aneurysm
Oesophageal Ulcer,
Varix
Heartburn
Myocardial Infarction
By Gastroenteritis and Peritonitis
abdominal pain is located
in the all quadrants
Typical symptoms; what to look for?
Pain?
How long? Where?
What kind?
Comfort position?
Vomiting?
Diarrhoea?
Constipation?
Bleeding?
Melena?
Haematemesis?
Trauma?
Mechanism of
injury?
Unconsciousness?
Signs of shock?
Pregnancy?
What is worth of knowing? I.
̶ Acute abdomen occurs suddenly, often from full health.
̶ Colic is the pulse of strong pain that comes in waves. It is typically
accompanied by pathology of the stomach, gallbladder and kidneys.
̶ Haematemesis (vomiting of fresh blood) is most common in ruptured
oesophageal varices or ulcers.
̶ Melena is a sign of bleeding from the upper part of the GIT, the blood has
already been digested, so the colour of the stool is black.
̶ Remember traumatic abdominal injuries, closed trauma can be
treacherous and endangers the patient with internal bleeding.
What is worth of knowing? II.
̶ The most common acute abdomen is appendicitis, the pain is most often
localized in the lower right quadrant.
̶ A typical sign of peritonitis (inflammation of the peritoneum) is abdominal
pain and tenderness, the patient responds significantly to palpation and
stretching of the lower limbs.
̶ Diarrhoea, vomiting, fever and diffuse abdominal pain are the most common
signs of gastroenteritis.
̶ For every woman in fertile age think about a possible pregnancy
(incl. extrauterine pregnancy)
What is worth of knowing? III.
̶ Rupture of the abdominal aortic aneurysm (AAA) is a rare, but very highrisk
complication. It manifests itself with a sudden sharp pain, which can
shoot into the back and groin. At the same time, it is often accompanied by
collapse, hypotension and pulsating mass seen during palpation of the
abdomen. The patient urgently needs surgery. Even with mere suspicion, call
112 immediately!
̶ Myocardial infarction can manifest itself also with pain in the upper
abdomen (among other things - pain behind the sternum, shortness of breath,
shooting into the left hand).
Although from the doctor's point of view the differential diagnosis
of abdominal pain is relatively broad and complex, the procedure
from the point of view of first aid is much simpler.
First Aid in abdominal pain
̶ Take medical history, perform a basic examination (SSS ABC)
̶ In case of signs of shock (weak pulse, tachycardia, not breathing normally,
impaired consciousness) proceed as in shock. Call 112 immediately!
̶ Consider not to give pain medication due to the risk of masking symptoms.
̶ Do not allow the patient to drink or eat!
̶ Leave patient in his comfort position, lower limbs bent, loosen tight clothing.
̶ First aid for abdominal trauma - see the relevant lecture.
When to call 112?
̶ Always if the patient is unconscious.
̶ Always if the patient has signs of shock (weak pulse, tachycardia, not
breathing normally, impaired consciousness).
̶ Always for trauma and hematemesis.
̶ Whenever we think of myocardial infarction or AAA.
̶ If a sudden acute abdomen is suspected and there are no other ways to take
the patient to the surgeon examination.
̶ In severe gastroenteritis with signs of dehydration, unless it is otherwise
possible to take the patient to a doctor.
̶ And always when in doubt.
Conclusion
Acute abdomen needs surgical examination. If the patient is unstable
or there is abdominal trauma, call 112.
With traumatic abdominal injury (both open and closed) and with
haematemesis there is always a risk of massive bleeding.
By sudden collapse and abdominal pain think about a ruptured AAA.
Learning outcomes
Student is able to
list the most
common causes of
abdominal pain.
1
Student knows the
typical symptoms
of abdominal pain.
2
Student knows
when abdominal
pain requires acute
examination by
a doctor.
3
References
̶ Text:
̶ Málek J., Knor J. a kol. Lékařská první pomoc v urgentních stavech. 1. vyd. Praha: Grada Publishing,
2019. 224 s. ISBN 978-80-271-0590-8
̶ Málek J., Dvořák A., Knor J. a kol. První pomoc. [online] Copyright © 3. Lékařská fakulta, Univerzita
Karlova v Praze, 2010-2012 [cit. 31.07.2020] available at: https://www.lf3.cuni.cz/3LF-782.html
̶ Furst J. First aid for abdominal pain. [online] 06.10.2015 [cit. 31.07.2020] available at:
https://www.firstaidforfree.com/first-aid-for-abdominal-pain/
̶ Pictures:
̶ https://www.firstaidforfree.com/how-to-assess-abdominal-pain/
̶ https://cz.pinterest.com/laurenmarie818/wilderness-first-aid/
̶ http://nigerianmedicals.com/vomiting-of-blood-the-causes-and-treatment/
̶ https://elitecarehouston.com/symptoms-of-appendicitis-when-to-seek-emergency-care/
̶ https://medlineplus.gov/ency/article/000162.htm
̶ https://www.bbc.com/news/science-environment-35557727
Simulation Centre, Faculty of Medicine, Masaryk University
2020