Central Abdominal Pain, Mass and Distension
Foregut pain: Epigastrium.
Midgut pain: Peri-umbilical
Hindgut pain: Hypogastrium
Referred pain: Away from the anatomical location of the pathology but in a region that shares a common embryological origin.

SMALL BOWEL OBSTRUCTION
CLASSIFICATION
INTRALUMINAL
Foreign bodies,Barium inspissation (colon),Bezoar,Inspissated feces,Gallstone,Meconium (cystic fibrosis),Parasites,Other (e.g., swallowed objects, enteroliths),Intussusception (usually associated with tumor in adults),Polypoid, exophytic lesions
INTRAMURAL
Congenital (rare in adults)   Atresia, stricture, or stenosis,Intestinal duplication,  Meckel's diverticulum,Inflammatory process -Crohn disease,Diverticulitis,Chronic intestinal ischemia or postischemic stricture,Radiation enteritis,Medication induced (nonsteroidal antiinflammatory drugs, potassium chloride tablets) Neoplasms    Primary bowel (malignant or benign)    Secondary (metastases, especially melanoma),Traumatic (e.g., intramural hematoma of duodenum)
EXTRINSIC
Adhesions_Congenital(Ladd or Meckel's bands),Postoperative,Postinflammatory (after PID),Hernias,Volvulus,External mass effect,Abscess,Annular pancreas,Carcinomatosis,endometriosis,Pregnancy,Pancreatic pseudocyst

Mesenteric Arterial Embolism
50%: of cases. Due to:
Atrial fibrillation
Myocardial infarction
Arrhythmia
Intra-cardiac tumor such as atrial myxoma or a paradoxical embolus

Clinically:
Sudden and severe epigastric or mid-abdominal pain
Vomiting and explosive diarrhea
25% of patients have had previous embolic events
The abdominal examination may be normal initially with signs of acute abdomen later
Slight to moderate abdominal distension is common
Bowel sounds are highly variable
The classic presentation is severe abdominal pain that is out of proportion to minimal or absent physical signs
Peritoneal signs or blood in the stools are late ominous signs implying infarction

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