Girdle pain in the abdomen most often occurs in acute pancreatitis and other pathologies of the pancreas (abscess, pancreatic necrosis, malignant tumor). The symptom is also observed in the pancreatic variant of duodenitis, diaphragmatic hernia, intercostal neuralgia. For diagnostic purposes, clinical and biochemical analyzes are carried out, instrumental studies - ultrasound, radiography and CT, ERCP and EFGDS. Rarely, diagnostic laparoscopy is used. Therapy of girdle abdominal pain involves the appointment of analgesics, antibiotics, infusion agents. Rarely, surgery is performed.
Inflammation of the pancreas is the main cause of girdle pain in the abdomen. The pain attack manifests suddenly, mainly after taking a large amount of fatty or spicy food. Soreness is localized at the top of the abdomen, radiates to the lower back, interscapular region. The pain is sharp, burning. Patients may describe it as a feeling of a tight belt. The pain syndrome is constantly present, aggravated in the supine position.
Against the background of pain, repeated vomiting develops, which does not bring relief to the patient. Vomit contains bile. In addition to girdle pain, there is discomfort throughout the abdomen, which is caused by flatulence. Purulent pancreatitis is characterized by debilitating pain accompanied by high fever. In biliary pancreatitis, a painful attack is accompanied by yellowness of the skin and mucous membranes.
The presence of girdle pain is possible with a pancreatic variant of duodenitis. The pains are permanent and are described by patients as sharp, burning or squeezing. They are provoked by errors in the diet, drinking alcohol. Soreness is localized in the upper abdomen as a belt. Pain is given in the back, in the left shoulder blade. The pain syndrome is combined with dyspeptic disorders: nausea, diarrhea, flatulence.
The condition mainly occurs with pancreatitis. After 10-15 days from the onset of the disease, the intensity of girdle pain increases, they take on a paroxysmal or pulsating character. Soreness in the abdomen is aggravated by the slightest movement, in the position on the left side and back. The symptom is accompanied by febrile or hectic fever, severe weakness, excessive sweating. On the left in the hypochondrium, the protective tension of the muscles is determined.
The sudden onset of unbearable girdle pain is a typical sign of organ destruction. Soreness radiates to the left abdomen, interscapular region and left shoulder. The intensity of the pain attack depends on the degree of damage to the pancreas. In 70% of cases, pain occurs after an episode of non-compliance with diet and alcohol abuse. Within a few days, the pain decreases, indicating the death of nerve endings.
A couple of hours after the onset of the pain syndrome, indomitable vomiting opens, containing streaks of blood, bile. There is a delay in stool and gases. The general condition of a person is severe or extremely severe, there may be hemodynamic disturbances. According to the clinical picture, pancreatic necrosis resembles the abdominal form of myocardial infarction and requires differential diagnosis.
Girdle pain in the abdomen
Malignant tumors are initially manifested by constant dull pains in the left upper quadrant of the abdomen, but as the neoplasm grows, the pain syndrome becomes girdle. Typical irradiation of pain in the back and lower back. Pancreatic pain increases sharply when the torso is bent forward and to the left. With malignant degeneration of the organ, patients quickly lose weight, up to anorexia and cachexia.
The occurrence of girdle pain in the upper abdomen occurs with 2-3 degrees of hernia of the esophageal opening of the diaphragm. The pain syndrome has a burning or compressive character. Patients report that pain bothers after eating, with intense physical exertion or straining. To reduce abdominal pain, a person takes a vertical position, takes deep breaths, and induces vomiting. Excruciating girdle pains are noted when the hernia is infringed.
Girdle pains in the abdomen develop with damage to the nerves passing in the 10-11 intercostal spaces, as well as with the pathology of the hypochondrium nerves. Patients report that the pains radiate in circles from the spine to the sternum. For such girdle pain, a sudden onset is typical, lasting from a few seconds to 3-5 minutes. During an attack, a person freezes and holds his breath.
Girdle pain in the abdomen is characteristic of drug-induced pancreatitis. To alleviate the attack, patients take a forced position: they lie on their side, pulling their knees to their chest. Soreness is accompanied by dyspepsia and weakness. Drug-induced pancreatitis may occur with treatment with certain antibiotics, antiretrovirals, cytostatics, and corticosteroids.
Examination of the patient begins with the collection of complaints, examination and palpation of the abdominal cavity. A gastroenterologist necessarily checks the symptoms of peritoneal irritation in order to exclude acute surgical pathology. In addition to pain in the abdomen, a specialist often detects a change in blood pressure and pulse, which confirms the general serious condition of a person. To clarify the diagnosis, laboratory and instrumental methods are prescribed:
If it is impossible to establish the causes of girdle abdominal pain using standard methods, diagnostic laparoscopy is used. The surgeon examines the surface of the organ in detail, looking for foci of necrosis, inflammation or tumor decay. For the diagnosis of non-digestive causes of pain syndrome, a consultation with a neurologist with a complete physical examination and assessment of the neurological status is recommended.
Ultrasound of the abdominal organs - a screening method for diagnosing the causes of girdle pain in the abdomen
In most cases, the appearance of girdle pain is a sign of a serious pathology of the digestive system, so self-medication is unacceptable. The patient needs to seek medical attention as soon as possible. Before the doctor arrives, you should not take painkillers or other medicines so as not to blur the clinical picture. To alleviate the patient's condition before establishing the causes of the pain syndrome, doctors can use analgesics, infusion therapy.
Treatment is carried out in a hospital. In the acute period, strict bed rest is recommended, after the condition improves, the restrictions are removed. A diet is shown, ice on the projection area of the pancreas. In all forms of pancreatitis, therapy is aimed at relieving the pain syndrome, for which antispasmodics and novocaine blockades are prescribed. In diseases that are accompanied by girdle pain in the abdomen, the following groups of drugs are effective:
When acute pancreatitis is complicated (necrosis, cysts, abscesses), surgery is indicated: endoscopic drainage, necrectomy or resection of the pancreas. The surgical approach is also justified in the phlegmonous form of chronic duodenitis. For the treatment of malignant neoplasia, a radical operation is performed - the removal of the entire organ along with the bile ducts and duodenum 12.