explain what is meant by the phenomenon of referred pain. is this phenomenon oft
ID: 258004 • Letter: E
Question
explain what is meant by the phenomenon of referred pain. is this phenomenon often seen in patients with acute pancreatitis?
A Case of Acute Pancreatitis: Case Presentation George Hendrix is a 38-year-old man who has abused alcohol his entire adult life. Recently, bnowi an episode of binge drinking, George experienced a gradual onset of pain in his uoper his upper ach abdomen that radiated to his back. The pain persisted for several hours and worsened e time that he ate. He also felt nauseous and experienced repeated episodes of vonm pain grew more intense and George decided to drive him his local hospital. The physician who examined George in the ER noted the follo when she performed a physical exam: Intense pain upon palpation of the upper the abdominal cavity, gaseous distension of the intestinal tract, and tachy exam findings, together with the history of alcohol abuse and the results of a CBC (complete blood conclude that George was suffering from a case of acute pancreatitis. The doctor immediately initiated the appropriate medical therapy self to the emergency room of wing findings eft quadrant of cardia. The physical cell count), serum chemistry panel, and abdominal ultrasound, led the physician toExplanation / Answer
Refered pain is defined as the pain which is felt at a place which is adjacent or other site where the pain stimulus is actually present. Various theories are proposed to explain the refered pain phenomenon which includes:
Convergent-projection theory: This theory states that afferent nerve fibers from tissues converge onto same spinal neuron
Convergence facilitation: According to this theory, nociceptive afferent inputs causes a irritable focus in other adjacent or connected segment causing refered pain
Axon reflex: This theory states that bifurcated neurons before connecting to dorsal horn may exist in muscle, skin and intervertebral disc which may cause referred pain
Hyperexcitability: Hyperexcitability of afferent neurons causes pain perception in a distant site other than the original site
Thalamic convergence: Thalamic convergence where summation of neural inputs occurs in the brain also supposed to mechanism behind referred pain
Examples of referred pain:
Myocardial ischemia- Upper chest/left limb
Liver and gall bladder disorders: Right tip of scapula
Pancreas disorders: Pancreas
Acute pancreatitis is a life threatening inflammatory process of pancreas where premature activation of excessive pancreatic enzymes destroy ductal tissue and pancreatic cells
Causes: Chronic alcoholism, gall stones, biliary obstruction, cholecystectomy, pancreatic obstruction due to tumors, cysts, abscesses, metabolic disturbances like hyperlipidemia, hyperparathyroidism, hypercalcemia, viral infections, drug induced (opiates, sufonamides, thiazides, steroids etc)
Is referred pain often seen:
3 out of 10 cases report referred pain which becomes very misleading in diagnosis. Necrosis in pancreatic tail will result in referred pain.
Other signs and symptoms include: Severe abdominal pain in mid epigastric area, general jaundice, abdominal tenderness, peritonitis, ascites, cullen's sign (gray blue discoloration of abdomen), turner's sign (gray blue discoloration of flanks), pneumonia, diminished breath sounds, dyspnea etc
Related Questions
Navigate
Integrity-first tutoring: explanations and feedback only — we do not complete graded work. Learn more.