Non-Abdominal Cause of Abdominal Pain
Region
Disease
Abdominal Presentation
Typical Presentation
Heart
Ischaemic Chest Pain,
Pericarditis
T5 Dermatome
Pain T2-T5, Radiate to T1 (Arm) and neck/Jaw
Pleura/Diaphragm
Pulmonary Embolism, Diaphragmatic Pleurisy
T5, T6 Dermatome
Costal Pleura: T2-T6
Lung
Right Lower Lobe Pneumonia
RUQ pain
Pleuritic chest pain
Oesophagus

T5, T6 Dermatome
T4-T6
Spine
Radiculopathy
Depends on Nerve Root
Depends on Nerve Root
Testes
Testicular Torsion
T10
Testicular Pain
Sigmoid Colon
Sigmoid Colon
T12
T12-L1
Uterus

T11, T12
Uterus body: T11-L2
Uterus Tube: T11-L1
external image dermatomes.png


Process of Referred Pain
Referred pain is pain felt distant to the source. Pain from deep tissue (parietal or visceral) converge on the same afferent spinal segment as an associated dermatome. The cerebral cortex interprets this signal as pain on the body surface map. Therefore there can be two types of pain, deep pain from the structure and referred pain (either over the source, or if the organ or skin has moved, away from the source).
referred_pain1.jpg
referred_pain2.jpg
Resources
NA Boon, NR Colledge, BR Walker. Davidson’s Principles & Practice of Medicine, 20th Ed. Churchill Livingston. 2006.
P Kumar, M Clark. Clinical Medicine, 6th Ed. Elsevier Saunders. 2005.
G Ahern, N Eizenberg. Referred Pain (Lecture) Week 14, MED2042, 2009.