The abdominal cavity is a large space in the human body that contains many vital organs. The abdominal cavity is adjacent to the thoracic cavity at the top and to the pelvic cavity at the bottom. Abdominal disorders are one of the most common reasons for visiting a doctor. The most serious of them, known in medicine as "acute abdomen", often require surgical treatment. Find out about the structure of the abdominal cavity, what functions are performed by the organs of the abdominal cavity, what tests are used in the diagnosis of diseases of the abdominal cavity and what symptoms may accompany abdominal cavity diseases.

The abdominal cavityis one of the torso cavities. In the anatomy of the abdominal cavity, there are many organs and structures that perform various functions. Abdominal diseases can negatively affect the functioning of the entire body. That is why all kinds of pain and dysfunctions of organs belonging to the abdominal cavity should be consulted with a doctor.

Abdominal cavity - anatomy

The abdominal space is bounded at the top by the diaphragm that separates it from the thoracic cavity. At the bottom of the torso, the abdominal cavity is adjacent to the pelvic cavity. The outer walls of the abdominal cavity are made up of several layers of tissue: fascia, muscles and skin with variously developed subcutaneous fatty tissue. At the back is the spine and the back muscles.

The abdominal cavity is conventionally divided into two parts: the upper, called the glandular layer, and the lower, called the intestinal layer.

The parenchymal organs of the abdominal cavity are located in the glandular layer, such as:

  • liver,
  • spleen
  • and pancreas.

The stomach also belongs to the glandular level. The rest of the digestive tract - the small intestine and the large intestine - are located in the intestinal layer.

Topographically, the anterior abdominal wall is divided into 3 horizontal parts:

  • epigastric region,
  • abdomen
  • and lower abdomen

and 3 vertical ones:

  • left side,
  • middle
  • and laws.

Together they form 9 quadrants, corresponding to the position of certain organs inside the abdominal cavity. For example, in the upper right quadrant there is the liver, in the upper left quadrant -the spleen, the lower right - the caecum with the appendix, and the left lower - the end sections of the large intestine.

The knowledge of the location of these organs facilitates the diagnosis of many diseases of the abdominal cavity, allowing for the initial differentiation of, among others, the origin of the pain.

The inside of the abdominal cavity is lined with the peritoneum - a thin membrane made of connective tissue. The peritoneum is divided into two plaques: wall plaques adjoining the walls of the abdominal cavity, and visceral plaques that surround the organs. Most of the organs of the abdominal cavity are located in the "bag" made of the peritoneum - this position is called intraperitoneal.

The peritoneum adjacent to the organs keeps them in the right position and prevents mutual displacement. However, it is worth knowing that there is a free space in the back of the abdominal cavity, located back from the peritoneum. We call it the extraperitoneal space.

Several important organs are located in the extraperitoneal space: the kidneys with the adrenal glands, most of the ureters, and the pancreas. In this part of the abdominal cavity there are also large vessels located along the spine - the aorta and the inferior vena cava. The branches of these vessels ensure blood circulation in all organs of the abdominal cavity.

The complex anatomy of the extraperitoneal space is of significant clinical importance. Operations on organs located in this space (for example - the pancreas) are one of the most technically difficult surgical procedures. Access to many of them is very limited due to the high risk of damaging large blood vessels.

Nerve structures also run along the front surface of the spine in the extraperitoneal space. Most of them belong to the so-called the autonomic nervous system, which is the part of the nervous system that works beyond our control.

The regulation of most abdominal functions (intestinal peristalsis, nutrient absorption, digestive gland function) is independent of our will. Large clusters of cells in the nervous system are called nerve plexuses.

One of the most famous plexuses located in the abdominal cavity is the visceral plexus, also known as the solar plexus. The solar plexus controls the work of most abdominal organs, which is why it has historically been called the "gut brain".

Abdominal cavity - functions

Most of the abdominal organs belong to the digestive system. The intestines occupy the largest volume of the abdominal cavity, the total length of which is from 6 to 8 meters. Inside the digestive tract, the processes of digestion and absorption of ingredients take placealimentary. Digestion would not be possible without the digestive glands.

The secretions of the liver and pancreas (bile and pancreatic juice respectively) contain chemicals that break down nutrients. The entire digestive tract is surrounded by a dense network of blood vessels that "collect" absorbed nutrients and transport them to the liver. This is the metabolic center of the whole organism - it transforms and stores nutrients depending on the current needs of the organism.

In addition to the elements of the digestive system, there are several organs in the abdominal cavity that perform functions not related to digestion. In the retroperitoneal space lie important structures of the urinary system - the kidneys and part of the ureters. The kidneys are responsible for the production of urine and the regulation of the body's water and electrolyte balance.

Directly adjacent to the kidneys are the adrenal glands, whose main task is the production of hormones:

  • cortisol,
  • aldosterone
  • and androgens.

The adrenal glands are therefore part of the endocrine system. In the upper left quadrant of the abdominal cavity lies the spleen - an organ of the hematopoietic system. The spleen has important immune functions and enables the destruction of used blood cells.

Abdominal cavity - diagnostic tests

Diagnostics of abdominal cavity diseases begins with collecting a detailed medical history and careful physical examination. In the examination of the abdominal cavity, many techniques are used - auscultation with a stethoscope, percussion and palpation (touch). The stethoscope allows you to hear the sounds of intestinal peristalsis.

Increased peristalsis is often associated with diarrhea. However, its absence may indicate a paralytic intestinal obstruction. By tapping, you can roughly delineate the boundaries of the abdominal organs (liver and spleen). The percussion examination also allows for the initial diagnosis of ascites (suppression of the percussion sound in the fluid-filled areas of the abdominal cavity).

Palpation of the abdominal cavitybegins with the so-called superficial palpation, i.e. examining the shallowest parts of the abdomen. Its purpose is to initially determine the location of pain, as well as to recognize the so-called muscle defense.

Muscle defense is a symptom of increased tension of the abdominal integuments and muscles, accompanying acute abdominal diseases. Muscle defense may prevent the rest of the palpation - the so-called deep palpation.

In deep palpation, you can locate the borders of the abdominal cavity organs and feel massive abnormalities (for example - large-size tumors).

When examining the abdominal cavity, special maneuvers are often used to initially differentiate the causes of the ailments. Research techniques are usually named after their authors. Examples of symptoms that are routinely checked in the abdominal examination include:

  • Chełmoński's symptom, consisting in the occurrence of severe ailments when hitting the right subcostal area. Positive Chełmoński symptom accompanies liver diseases, in particular acute cholecystitis.
  • Blumberg symptom, triggered by deep pressure on the abdomen followed by a quick withdrawal of the hand. If the patient feels severe pain when the pressure is released, the symptom is considered positive. Blumberg's symptom belongs to the group of so-called peritoneal symptoms, indicating the presence of peritonitis.
  • Goldflam's symptom, used in the diagnosis of certain kidney diseases. Goldflam's symptom is investigated by tapping lightly on the lumbar region with a fist. Severe pain at the time of shock indicates acute nephritis or an attack of renal colic.

Although a thoroughphysical examinationprovides a lot of valuable information, the diagnosis of abdominal diseases usually requires additional tests. The first are often widely availableimaging tests- ultrasound or X-ray (X-ray).

No imaging examination is an ideal tool. The selection of the study is made taking into account the clinical data, because there are strict indications for the performance of specific types of tests.

For example,X-ray of the abdominal cavityallows you to recognize perforation (or perforation) of the gastrointestinal tract. In this condition, the X-ray shows free air under the diaphragm (under normal conditions, the diaphragm fits tightly to the abdominal organs).

X-rays are also used in the diagnosis of renal colic. In many cases, the photo shows stones within the kidney or descending towards the ureter.

Ultrasound examinationis useful primarily in the diagnosis of diseases of parenchymal organs (including liver, pancreas and kidneys). An example of a disease diagnosed using ultrasound is cholecystolithiasis.

If widely available USG and X-ray examinations do not provide sufficient diagnostic data, more advancedimaging tests- computed tomography (CT) or magnetic resonance (MR) of the abdominal cavity.

A valuable supplement to the abdominal imaging examinations areendoscopic examinations . UsedThey are primarily used in the diagnosis of diseases of the gastrointestinal tract, the interior of which cannot be seen in ordinary imaging tests.

The most common endoscopic examinations are:

  • gastroscopy (examination of the esophagus, stomach and duodenal start)
  • and colonoscopy (examination of the large intestine).

Endoscopic examinations are most often used to diagnose inflammatory and neoplastic diseases. In justified cases, more complex tests, such as ERCP (endoscopic retrograde cholangiopancreatography) are performed.

It is a test that combines endoscopic techniques with X-ray imaging and is used for the accurate diagnosis of biliary tract diseases. Endoscopic examinations are usually combined with the taking of specimens for histopathological examination, which often allows for a final diagnosis.

Another tool helpful in the diagnosis of abdominal diseases islaboratory tests . There are several specific laboratory markers whose elevated values ​​correspond to disturbances in the functions of specific organs. Among them, the so-called

is most often marked
  • liver tests (ALT, AST) accompanying liver damage,
  • amylase and lipase, evidence of pancreatic damage,
  • as well as renal parameters (creatinine, urea), which increase in impaired kidney function.

Depending on the clinical situation, inflammatory markers and neoplastic markers can also be determined. Suspicion of infectious diseases often requires microbiological tests.

Abdominal cavity - diseases

Abdominal diseases can have a variety of causes - infectious, traumatic, cancerous, congenital or inflammatory. Regardless of the etiology of the disease, at the initial stage of diagnosis it is necessary to answer the question whether the disease is an emergency and may pose a threat to the patient's life. In such a case, diagnosis must be made quickly and treatment instituted almost immediately.

Sudden diseases of the abdominal cavity, which may threaten the patient's life, are referred to in medicine as "Sharp belly". An acute abdomen is a group of symptoms that accompany many serious diseases of the abdominal cavity. Their common feature is the need for quick treatment - usually surgical.

Causes of an acute abdomen include:

  • acute appendicitis,
  • massive gastrointestinal bleeding,
  • acute cholecystitis,
  • intestinal obstruction
  • or peritonitis.

After exclusion of emergencies, diagnostics of diseases of the abdominal cavityis proceeding as planned. The key to a correct diagnosis may be a detailed medical history. The location and type of the perceived ailments often allow for the initial orientation of the diagnosis.

Diseases of the abdominal cavity, however, require high vigilance - there are situations in which the symptoms seemingly coming from the abdominal cavity indicate a disease of other organs. An example is lobar pneumonia, which, especially in children, can run under the so-called "Abdominal mask".

In the case of abdominal pain in women, always exclude pathologies of the reproductive system (adnexitis, rupture of ectopic pregnancy). Their initial symptoms may be the same as in the case of abdominal diseases (e.g. acute appendicitis).

The information provided by the patient during the medical interview usually allows classifying his disease to a group of diseases of a specific etiology. In the case of dyspepsia, i.e. postprandial pains, rapid satiety, flatulence and nausea, the most common causes are diseases of the upper gastrointestinal tract - mainly among them:

  • peptic ulcer disease,
  • gastritis
  • and gastroesophageal reflux disease.

Acute diarrhea usually indicates a gastrointestinal infection. Chronic diarrhea may accompany malabsorption disorders. If you have a fever or blood in your stools, think about inflammatory bowel disease:

  • Crohn's disease
  • or ulcerative colitis.

Neoplasms are a particularly "tricky" group of abdominal diseases. In the early stages of development, they usually do not cause pain. If undesirable symptoms in the abdominal cavity are accompanied by chronic weakness or weight loss, malignancies should always be excluded.

  • Abdominal pain - causes
  • Early symptoms of gastrointestinal neoplasms: pancreas, stomach, esophagus and intestines cancer
  • Abdominal obesity

Category:

Gastrology