View source for Painful right lower abdomen syndrome

__TOC__

Painful lower abdomen syndromes can be divided to:

*Painful right lower abdomen syndrome.
*[[Bolestivý syndrom levého podbřišku|Painful left lower abdomen syndrome]].

==Acute appendicitis==

*The most common cause of pain in the right lower abdomen.
* It typically manifests as pain starting around the navel, which moves to the P lower abdomen and gradually increases in intensity.
*With the transition of inflammation to the [[peritoneum]],  [[známky peritoneálního dráždění|peritoneal symptoms]] appear ([[Pléniesovo znamení|Plénes sign]], [[Rowsingovo znamení|Rowsing sign,]] [[Blumbergovo znamení|Blumberg sign]]), worsening pain when moving and coughing, pain per rectum when palpated in Douglas space.
*Diagnostics
**Monitoring clinical development and abdominal findings;
**[[Ultrazvuk/Diagnostické aplikace ultrazvuku|USG]] has a large percentage of false negative results (depending on the investigator's experience);
**In the laboratory findings, the leukocytosis is between 10–20 000.
{{Podrobnosti|Akutní appendicitida}}

==Right-sided renal colic==

*It is characterized by severe colic-like pain in the back of the lumbar region (along the ureter).
*The pain radiates to the groin, testicle or labia and is often accompanied  by [[Hematurie|hematuria]], [[dysurie|difficulty urinating]]. 
**Similar symptoms; How many irritation [[močovod|ureters]] and hematuria are also in retrocaecal appendicitis. The appendix urges the P ureter.
*How much is usually caused by [[Konkrementy|concretion]]
*It rarely arises by bending of the ureter in [[ren migrans]] (clinically impossible to urinate and the pain disappears immediately after urination, the kidney palpable as a smooth formation in the uterine hip and proven here in urography).
*In [[Infekce močových cest|inflammation of the urinary tract]] (cystopyelitis, [[pyelonefritida|pyelonephritis]]) there is colic-like pain with high temperature and chills, a significant finding of  [[Leukocyty|leukocytes]] in urine.
*Diagnostiks: 
**X-ray of kidney and small pelvis (lying down, native);
**The USG shows the expansion of the hollow system;
**[[urografie|urography]];
**Laboratory findings of erythrocytes in urine.
{{Podrobnosti|Renální kolika}}

==Acute gastroenteritis==

*There is often a history of dietary error.
*Manifestations include
**Abundant [[zvracení|vomiting]] with a feeling of relief (in appendicitis it does not relieve), which precedes pain (in appendicitis first pain and then reflex vomiting);
**Diarrhea (rather constipation in appendicitis);
**High temperatures (for appendicitis up to 38&nbsp;°C) and sweating;
**With pressure on the right lowe abdomen, the pain does not worsen.
{{Podrobnosti|Průjmová onemocnění}}

==Acute cholecystitis==

*It occurs with low gallbladder deposition, large hydrops or pericholecystitis. The pain spreads to the P lower abdomen and gives the appearance of appendicitis. It is usually used in middle-aged women with a history of biliary problems.
*Diagnostiks: USG.
{{Podrobnosti|Akutní cholecystitida}}

==GD ulcer perforation==

*Perforation typically begins in the abdomen with sudden severe pain and muscle contraction (in appendicitis, the worsening of pain is gradual).
*The contents of the stomach run down to the P pit of the hip, where the peritoneum is irritated and the pain shifts.
*In the anamnesis we find stomach problems or already detected and treated gastroduodenal ulcer disease, abuse of [[Neopioidní analgetika|nonsterodial antiphlogistics]] or ulcer disease in the family history.
* Diagnosis: X-ray on which is pneumoperitoneum. It has a high percentage of false negative results. If the X-ray is negative, the pneumoperitoneum can be detected on CT.
{{Podrobnosti|Vředová choroba gastroduodena}}

==Lymphadenitis mesenterialis==

*The symptoms resemble accute appendicitis.
*It is manifested by pain in the P lower abdomen.
*It occur mainly in children after respiratory infections.
*Symptoms are non-specific; Pain, fever and non-deteriorating general condition.
*Enlarged nodules may be evident on the USG.

==Adnexitis==

*It usually starts after [[Menstruace|menstruation]].
*It is manifested by pain in the P lower abdomen radiating to the thigh. It is usually accompanied by discharge from the vagina and high temperature. There is no muscle contraction, vomiting and loss of appetite.
*Examination by the vagina shows pain when moving the cervix and there may be a palpable inflammatory tumor adnexa.
*Diagnosis of gynecological ultrasound (small amount of fluid in Douglas space).
{{Podrobnosti|Adnexitida}}

==Ectopic pregnancy==

*The history of the last menstrual disorder.
*Ovarian rupture most often occurs at the time of subsequent ovulation, which results in significant bleeding into the abdominal cavity.
*It is manfised by pain in the P (or L) lower abdomen, discharge, light vaginal bleeding, rectal [[tenesmus|tenesmas]] and hemorrhagic [[šok|shock]] (paleness, [[tachykardie|tachycardia]], hypotension).
*Diagnosis by gynecological USG and determination of [[hCG]] levels.
{{Podrobnosti|Mimoděložní těhotenství}}

==Ovarian torsion (a cyst, cystadenoma) or uterine myoma==

*It is manifested by severe pain in the lower abdomen (often-colic like), which shoots into the cruciate ligament (similar pain is also present in the [[akutní skrótum|torsion of the testes]]).
*Diagnosis of gynecological ultrasound.
{{Podrobnosti|Torze adnex}}

==Crohn's disease==

*Typical with its history of chronic diarrhea.
*In an acute attack, it is manifested by high temperatures. diarrhea with blood and mucus with high leukocytosis.
*In the ileocecal localization, it gives the expression of appendicitis during acute exacerbation.
{{Podrobnosti|Crohnova choroba}}

==Ulcerative colitis ==

*As with Crohn's disease, there is a history of chronic diarrhea.
{{Podrobnosti|Ulcerózní kolitida}}

==Carcinoma of the cecum==

*It may be manifested by pain in the P lower abdomen. In elderly patients, there may be a palpable tumor that needs to be distinguished from a periapendical infiltrate or [[absces|abscess]] (as opposed to a palpable pain).
*Anamnestically, we find digestive problems and anemia.
{{Podrobnosti|Kolorektální karcinom}}

==Other==

*'''Mechanical ileus''' in the lower part of the colon in the resting Bauhin valve- cecal distention and pain in the P abdomen;
*'''[[tuberkulosa|Tuberculosis]] a [[aktinomykosa|actinomycosis of the]]''' ileocecal landscape;
*'''Torso omenta''';
*'''Inflammation of [[Meckelův divertikl|Meckel's diverticulum]]''' (clinically indistinguishable from appendictis);
*'''[[Pleuritida|pleurisy]] a [[pneumonie|pneumonia]]''' (when there maybe be muscle contraction).

<noinclude>

==References==
===Related articles ===

*[[Bolestivý syndrom levého podbřišku|Painful left lower abdomen syndrome]]
*[[Bolestivý syndrom nadbřišku|Abdominal pain syndrome]]

===Sources===

* PASTOR, Jan. ''Langenbeck's medical web page''  [online]. [feeling. 2009]. <langenbeck.webs.com>.
* ZEMAN, Miroslav, et al. ''Special surgery. ''2nd edition. Prague: Galén, 2006. 575 pp.  <nowiki>ISBN 80-7262-260-9</nowiki> .

</noinclude>

[[Kategorie:Chirurgie|Category : Surgery]]
[[Kategorie:Gastroenterologie|Gastroenterology]]
[[Kategorie:Vnitřní lékařství|Internal medicine]]