Everyone can suffer from pain in the stomach, at one time or the other and we usually ignore it. But when the pain is sudden and severe abdominal pain then it is termed as acute pain and this should not be ignored.

Often the following can be expected with acute pain:

Acute abdomen pain is usually synonymous with rapid onset of the symptoms which might indicate life threatening intra-abdominal pathology.
Pain is just a feature and not necessary that it is present at all times. An acute abdomen which is pain free usually occurs in children and women who are in their third trimester of pregnancy.
The differential diagnosis is difficult and wide especially in primary care. This is because the different organs within their peritoneal cavity might have different areas of referred pains.
Abdominal pain usually happens to be in the top three symptoms when patients present their state in the emergency and accident departments. But only few of these have acute abdominal pain.
Management of the abdominal pain should be the primary focus and an assessment should be done to reach the differential diagnosis so that care can be given accordingly.
The clinical evaluation regarding abdomen pain can change quickly. Any diagnosis which had been made can change and both doctor and patient should not be hesitant and seek other treatment.
Conditions which might cause acute abdomen pain are:

Meckel's diverticulitis or Acute appendicitis
Acute cholecystitis
Ectopic pregnancy
Acute pancreatitis.
Peptic ulcer disease
Diverticulitis.
Intestinal obstruction, including paralytic ileus (adynamic obstruction)
Pelvic inflammatory disease.
Gastrointestinal (GI) haemorrhage
Gastroenteritis.
Acute intestinal ischaemia/infarction or vasculitis.
Acute urinary retention
Renal colic or renal tract pain
Testicular torsion
Abdominal aortic aneurysm
Non surgical diseases like pericarditis, sickle cell crisis, acute intermittent porphyria, HIV-associated lymphadenopathy, bowel disease, typhoid, opiate withdrawal, enteritis, pneumonia, myocardial infarction and hepatitis.
Rare causes might include thromboemboli, phytobezoar, and phytobezoar
Diagnosis of abdominal pains:

Patients can be ordered to get their blood tests done. Also if need be then imaging can also be referred to them.
Following tests can be done to rule out the condition causing the abdominal pain:
Blood Tests: these include FBC, LFTs, glucose, amylase, clotting, calcium and arterial blood gas for pancreatitis
Crossmatch or group and save
Pregnancy test in women of childbearing age
Blood cultures
Peritoneal lavage in case of an abdominal trauma
Urine analysis
X ray of the abdomen, ultrasound, CT scan
ECG and cardiac enzymes
Laparoscopy should be a routine procedure

Don't Ignore the Acute Abdominal Pain

Gallbladder removal, termed as cholecystectomy, is regarded as one of the most commonly opted surgical procedures. Laparoscopic surgery for cholecystectomy is the process of removing the gallbladder with laparoscopic techniques. It is a minimally invasive surgery where the surgical procedures are performed with the assistance of different minute instruments and a video camera.

Advantages of Laparoscopic surgery for cholecystectomy
The most commendable reason why people favour laparoscopic surgery is that in place of having to undergo a five to seven-inch incision, this surgical process requires only four small incisions in the abdomen. Moreover, there is minimal post-operative pain and the patients are able to recover faster than patients who have undergone open gallbladder surgery. Most patients can go home the same day as the surgery and can have a quick return to day to day activity.

Determining whether you are a good candidate for laparoscopic surgery
Even though there are numerous benefits of laparoscopic gallbladder surgery, the process may not be suitable for all candidates as it is generally not suggested for patients who suffer from severe and complicated gallbladder disease or have a history of undergoing upper abdominal surgery. A comprehensive medical evaluation by the physician and subsequent consultation with the surgeon is essential in determining whether a patient is a suitable candidate for laparoscopic removal of the gallbladder.

Undergoing the laparoscopic surgery for gallbladder removal
Once you are recommended to undergo laparoscopic gallbladder removal, your doctor will advise you certain preoperative measures that you must follow before the surgery. It is suggested to take a shower the night before the operation and not to eat anything from the night before the operation. Also, drugs such as anticoagulants, arthritis medicines, and Vitamin E medications must also be stopped temporarily for several weeks before the surgery.

The surgery is performed under general anaesthesia. Therefore, the patient is asleep all through the process. The surgeon first inserts the cannula into the abdomen and then a laparoscope is connected to a specific camera through the cannula. Subsequently, other cannulas are also inserted which help the surgeon to separate the gallbladder from the attachments and then remove it completely through one of the apertures. Once the surgeon removes the gallbladder successfully, the small incisions are closed with dissolvable surgical tape or glue.

It is an overall safe procedure, and the rate of complications is much lower which makes it the most effective and popular treatment option.

Laparoscopic Surgery For Cholecystectomy - Who Should Go For It?

Types of abdominal and pelvic surgical incision

At the time of a surgical procedure, while making an incision a doctor has to take care of a number of factors before making an incision. Considering a number of factors, different types of incisions have come into fore, such as 

Midline Incision: It s the commonest incision and is done along the linea alba (fibrous structure running through the mid of the abdomen). These are preferred, especially in diagnostic laparotomy as it permits a wide access to the abdomen.
Pfannenstiel Incision: It is transverse in nature, extending from the umbilicus to the pubic-symphysis. It is generally employed for abdominal hysterectomy of benign nature and caesarean section.
Chevron Incision: It is an incision under the rib-cage and is done on the abdomen. It starts from beneath the ribs on the right abdomen and extends till the other mid axillary line. Thus, the entire abdominal width is incised for proper reach into the liver. The incision can be up to 2 feet.
Kustner Incision: It is transverse in nature and extends from the symphysis pubis till the iliac spine (anterior). This type of incision takes time to perform. A Pfannenstiel incision offers more exposure than a Kustner incision.
Lanz Incision: It is a variation of the more common mcburney-incision (also known as Gridiron s incision). It is generally used for open appendectomies. There are quite a few variations for this type of an incision.
Gridiron s incision: It is done for appendectomies. It is an oblique short incision which is done in the lower right quadrant in the abdomen.
Kocher s Incision: It is oblique in nature, extending from the abdominal upper right quadrant and is generally used for performing an open cholecystectomy. Gallbladder, biliary tract and certain liver operations can be suited for a Kocher s incision. This however is different from the same named incision used for the thyroid gland surgery.
Cherney Incision: It is transverse in nature. It allows a great range of exposure for the pelvic sidewall. It is less painful than a midline incision. It allows for the greatest pelvic exposure and hence is a widely preferred and practiced incision.

8 Types Abdominal and Pelvic Surgical Incisions

There is hardly any individual across the world, who has not experienced abdominal pain. In most instances, these aches are not very serious and can be diagnosed and treated by addressing the underlying condition. It is very crucial to recognize the symptoms which are severe and know when an individual should seek medical assistance. 

Most common causes of abdominal pain: 

Some of the most common causes of abdominal pain include Indigestion, infection, menstrual cramps. It may also be due to food poisoning and allergies, irritable bowel syndrome, gas formation and bloating, lactose intolerance, pelvic inflammatory disease or ulcers and hernia, gallstones and kidney stones, urinary tract infection, Crohn s Disease or gastroesophageal reflux disease. 

Some patients have abdominal pain but the source of pain lies in the spine. These patients are often seen by multiple doctors and have undergone many tests but their diagnosis is never established. These patients should visit a pain specialist to reach a diagnosis and treatment plan. They have conditions like neuropathies or facet joint arthritis which cause abdominal pain due to a condition known as referred pain. 

Symptoms of abdominal pain that are cause for concern: 

Abdominal pain along with any sign of dehydration or fever or is unable to pass stools.
Abdominal pain associated with tenderness in the abdomen, painful and frequent urinations or persistent loose motions or bloody/ tarry stools. 
Severe or recurrent abdominal pain. 
Determining the cause of abdominal pain and treating it.

Detailed medical history and thorough physical examination would be performed. Further tests like USG, Endoscopy etc may be needed to reach a diagnosis. 
The treatment of abdominal pain is entirely dependent on the cause of the pain.

Abdominal Pain - Know the Causes Behind It!

Abdominal Laparoscopy is a surgical diagnostic procedure, which is used to examine the organs inside the abdomen. It is an invasive procedure, but only small incisions are made.
The procedure is usually done in the hospital and the patient is given general anaesthesia to make the procedure pain free. The laparoscope is inserted through an incision in the abdominal wall. As it moves along, the image of the inside of your abdomen is then seen on the monitor. After the exam, laparoscope and instruments are removed and the cuts are closed. Laparoscopy is usually done as an outpatient procedure. This means that you will be able to go home the same day.

Why Is laparoscopy performed?
Laparoscopy is often used to identify the source of abdominal pain. It is usually performed when x-rays or ultrasound are unable to determine the root cause of the problem. Laparoscopy allows your doctor to see inside your body in real time and helps to diagnose or help discover what the abdominal problem is.

Tips to deal with laparoscopic surgery

Before Surgery

    The first and the foremost thing is to prepare yourself for the surgery by watching some videos and going through some blogs on it as doing so will help you clear your doubts
    Do not eat or drink anything 8 hours before the procedure
    Make sure someone accompanies you on the day of the surgery
    Fix your Pre Op appointment to ask any questions or address any concerns regarding the surgery, anaesthesia, etc
    Shave the area where the surgery will be performed. This will substantially reduce itchiness
    Lastly, prepare your hospital bag and discuss it with the person who is going to accompany you so that he/she knows what all you packed

After Surgery

    Don t lie down in bed all the time. Keep yourself active by moving every two hours as it promotes healing and helps eliminate gas pain
    Wear comfortable clothing
    Do not take bath for a week. However, you can take a shower 24 hours post surgery
    Drink at least 1.5 to 2 litres of water per day to prevent constipation. If constipated, take a stool softener.
    While sneezing or coughing, hold a pillow against your stomach to lessen the pain
    Roll onto your side and sit up using your arms for support and then stand up
    Don t drive for two weeks
    Refrain yourself from intercourse, douching, and swimming
    Make sure to visit your doctor 2 to 3 weeks post surgery to make sure your wounds are healing

It might take some time for the wounds to heal, but in case of any prolonged pain do remember to consult your doctor immediately.

Easy Tips to Deal with Abdominal Laparoscopy

As soon as one is released from hospital after going through an abdominal surgery, the patient must make a checklist and an early recovery strategy before leaving home. Do follow the following tips and recover soon.

    Do make prior arrangements for a safe and comfortable journey back to home. Ensure that you have made transportation arrangements to go home safely. Use your own car or book any cab or take any friend s help. Place a cushion over your abdomen to keep it safe from jerks.
    Do go for post-surgery checkup. Book an appointment with your surgeon post-surgery. This would ensure that surgery did not cause any side-effect.
    Understand the schedule for taking medicines. Usually the patients are given painkillers. If you think you are not getting relief from it then ask your surgeon to prescribe you an alternative. Patients are likely to suffer from constipation post an abdominal surgery. If that happens, intake more fibrous food, fluids and indulge in light physical activities. Patients can also ask for cheaper alternative medicines.
    Check for certain signs and symptoms and take adequate steps:
        Take adequate sleep. There are chances that you may feel dizzy and fatigue, therefore one must observe change in sleep patterns. Have patience. Things will become normal in due course of time.
        You will also be subjected to little pain from the incision. Take your medicines as directed in order to get an early relief from pain.
        Draining of yellow color liquid from the incision in little quantities post the surgery is normal. If the drainage continues even after 7 to 14 days with redness around incision, it is a clear symptom of infection. Consult your surgeon immediately for the cure.
        Removal of urinary catheter from the bladder may cause minor difficulties during urination. Situation will become normal in few days. If discomfort persists, consult your surgeon.
    Identify the following dangerous symptoms and call your doctor right away.
        Persistent vomiting or nausea
        Incapability to digest food or fluids
        Swelling in leg
        Abnormal body temperature
        Infection at the surgical site
    Maintain a healthy and supervised lifestyle post surgery.
        It will take few days to return to your normal routine life. So have patience until then.
        Go for morning and evening walks. Avoid heavy exercises as such activities may cause physical strain.
    Take care of your surgical incision
        Surgical incision should be regularly cleaned or washed gently. Try to keep the surgical site dry until the stitches are removed.
        After 5-7 days of surgery, the stitches would be removed by the surgeon. Avoid putting ointment on the stitches until then. It will take few weeks for the scars to fade.

Under proper care and supervision, the patient will soon recover post an abdominal surgery and will be able to get their life back on track.

Tips to Recover from an Abdominal Surgery

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