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Referred Abdominal Pain


  • Generally, this either means that pain within the abdomen is referred from a pathological site to a non-involved abdominal site; or that pain within the abdominal cavity is referred to a non-involved site outside the abdomen.
  • Referred abdominal pain (RAP) can also mean that pain from a pathologic site outside the abdominal cavity is referred to a non-involved site within the abdomen.

  • As described in description and causes, there may be a multitude of different symptoms.

  • A pair of sites may share development from the same embryologic tissue, and may share innervation to some extent.  Pain at the one site may be referred to the other site, even though the pathologic site is not painful initially.
  • Inflammation at one site may cause pain at an adjacent site on which it abuts.
  • A widespread surface like the peritoneum may transmit pain from one organ that touches the perineum, to another.
  • Examples of RAP:
    1. Epigastric pain (the midline of the abdomen above the navel) may be the initial symptom of appendicitis.
    2. A retrovesical appendix hidden behind the bladder may abut the bladder and cause bladder discomfort.
    3. Acute cholecystitis (an inflammed gallbladder) may cause shoulder pain
    4. Acute inferior wall myocardial infarction (heart attack where bottom wall of the heart is damaged) may cause abdominal pain

  • It is difficult to tell whether abdominal pain is referred or not.  If there is localized pain without tenderness, or localized pain without pain-on-motion, this somewhat favors referred pain.

  • Treatment is that of the underlying condition.

  • Misdiagnosis, or delay in diagnosis, of the actual cause of pain

  • Consult your physician.













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