Urologic causes of the acute abdomen

Michael Koch, W. S. McDougal

Research output: Contribution to journalArticle

Abstract

Most acute urologic processes in their classic presentation are easily distinguished from nonurologic causes of the acute abdomen. Unfortunately, nonclassic presentations of urologic disease are common, and even the most astute practitioner may be fooled. Genitourinary organs share neural pathways with other visceral structures. The kidneys are richly innervated by autonomic fibers from the celiac plexus, the thoracic and upper lumbar splanchnic nerves, the intermesenteric plexus, and the superior hypogastric plexus. The testes and lower ureters receive a blend of sympathetic and parasympathetic innervation from the autonomic nervous system through the pelvic ganglia. These plexes also supply innervation to other intraabdominal visceral structures. Because of this significant overlap of autonomic innervation between the genitourinary structures and other visceral organs, referred pain is common. The iliohypogastric, ilioinguinal, and genitofemoral nerves arise from the lower thoracic and upper lumbar segments of the spinal cord and supply cutaneous innervation to the lower abdomen and the genitalia. A number of retroperitoneal inflammatory processes, whether originating from a genitourinary organ or otherwise, may cause irritation of these nerves. Inflammatory processes may thus cause referral of pain to the lower abdominal quadrants or the genitalia. In this article, an attempt is made to present those genitourinary disease entities that are most commonly confused with non-urologic causes of the acute abdomen. Because of space limitations, a number of disease processes, such as acute renovascular events, spontaneous rupture of the bladder, and severe prostatic infections, will not be discussed. This is not to deny their importance as disease entities but rather acknowledges their infrequent presentations as acute abdominal processes. Three primary areas are included in this article: renal and perirenal infections, obstructions of the ureter and renal pelvis, and acute intrascrotal events.

Original languageEnglish (US)
Pages (from-to)399-413
Number of pages15
JournalSurgical Clinics of North America
Volume68
Issue number2
StatePublished - 1988
Externally publishedYes

Fingerprint

Acute Abdomen
Genitalia
Ureter
Thorax
Hypogastric Plexus
Celiac Plexus
Referred Pain
Splanchnic Nerves
Kidney
Urologic Diseases
Neural Pathways
Kidney Pelvis
Spontaneous Rupture
Autonomic Nervous System
Infection
Ganglia
Abdomen
Testis
Spinal Cord
Urinary Bladder

ASJC Scopus subject areas

  • Surgery

Cite this

Urologic causes of the acute abdomen. / Koch, Michael; McDougal, W. S.

In: Surgical Clinics of North America, Vol. 68, No. 2, 1988, p. 399-413.

Research output: Contribution to journalArticle

Koch, M & McDougal, WS 1988, 'Urologic causes of the acute abdomen', Surgical Clinics of North America, vol. 68, no. 2, pp. 399-413.
Koch, Michael ; McDougal, W. S. / Urologic causes of the acute abdomen. In: Surgical Clinics of North America. 1988 ; Vol. 68, No. 2. pp. 399-413.
@article{16202102a1eb4a3da69333c609c94e83,
title = "Urologic causes of the acute abdomen",
abstract = "Most acute urologic processes in their classic presentation are easily distinguished from nonurologic causes of the acute abdomen. Unfortunately, nonclassic presentations of urologic disease are common, and even the most astute practitioner may be fooled. Genitourinary organs share neural pathways with other visceral structures. The kidneys are richly innervated by autonomic fibers from the celiac plexus, the thoracic and upper lumbar splanchnic nerves, the intermesenteric plexus, and the superior hypogastric plexus. The testes and lower ureters receive a blend of sympathetic and parasympathetic innervation from the autonomic nervous system through the pelvic ganglia. These plexes also supply innervation to other intraabdominal visceral structures. Because of this significant overlap of autonomic innervation between the genitourinary structures and other visceral organs, referred pain is common. The iliohypogastric, ilioinguinal, and genitofemoral nerves arise from the lower thoracic and upper lumbar segments of the spinal cord and supply cutaneous innervation to the lower abdomen and the genitalia. A number of retroperitoneal inflammatory processes, whether originating from a genitourinary organ or otherwise, may cause irritation of these nerves. Inflammatory processes may thus cause referral of pain to the lower abdominal quadrants or the genitalia. In this article, an attempt is made to present those genitourinary disease entities that are most commonly confused with non-urologic causes of the acute abdomen. Because of space limitations, a number of disease processes, such as acute renovascular events, spontaneous rupture of the bladder, and severe prostatic infections, will not be discussed. This is not to deny their importance as disease entities but rather acknowledges their infrequent presentations as acute abdominal processes. Three primary areas are included in this article: renal and perirenal infections, obstructions of the ureter and renal pelvis, and acute intrascrotal events.",
author = "Michael Koch and McDougal, {W. S.}",
year = "1988",
language = "English (US)",
volume = "68",
pages = "399--413",
journal = "Surgical Clinics of North America",
issn = "0039-6109",
publisher = "W.B. Saunders Ltd",
number = "2",

}

TY - JOUR

T1 - Urologic causes of the acute abdomen

AU - Koch, Michael

AU - McDougal, W. S.

PY - 1988

Y1 - 1988

N2 - Most acute urologic processes in their classic presentation are easily distinguished from nonurologic causes of the acute abdomen. Unfortunately, nonclassic presentations of urologic disease are common, and even the most astute practitioner may be fooled. Genitourinary organs share neural pathways with other visceral structures. The kidneys are richly innervated by autonomic fibers from the celiac plexus, the thoracic and upper lumbar splanchnic nerves, the intermesenteric plexus, and the superior hypogastric plexus. The testes and lower ureters receive a blend of sympathetic and parasympathetic innervation from the autonomic nervous system through the pelvic ganglia. These plexes also supply innervation to other intraabdominal visceral structures. Because of this significant overlap of autonomic innervation between the genitourinary structures and other visceral organs, referred pain is common. The iliohypogastric, ilioinguinal, and genitofemoral nerves arise from the lower thoracic and upper lumbar segments of the spinal cord and supply cutaneous innervation to the lower abdomen and the genitalia. A number of retroperitoneal inflammatory processes, whether originating from a genitourinary organ or otherwise, may cause irritation of these nerves. Inflammatory processes may thus cause referral of pain to the lower abdominal quadrants or the genitalia. In this article, an attempt is made to present those genitourinary disease entities that are most commonly confused with non-urologic causes of the acute abdomen. Because of space limitations, a number of disease processes, such as acute renovascular events, spontaneous rupture of the bladder, and severe prostatic infections, will not be discussed. This is not to deny their importance as disease entities but rather acknowledges their infrequent presentations as acute abdominal processes. Three primary areas are included in this article: renal and perirenal infections, obstructions of the ureter and renal pelvis, and acute intrascrotal events.

AB - Most acute urologic processes in their classic presentation are easily distinguished from nonurologic causes of the acute abdomen. Unfortunately, nonclassic presentations of urologic disease are common, and even the most astute practitioner may be fooled. Genitourinary organs share neural pathways with other visceral structures. The kidneys are richly innervated by autonomic fibers from the celiac plexus, the thoracic and upper lumbar splanchnic nerves, the intermesenteric plexus, and the superior hypogastric plexus. The testes and lower ureters receive a blend of sympathetic and parasympathetic innervation from the autonomic nervous system through the pelvic ganglia. These plexes also supply innervation to other intraabdominal visceral structures. Because of this significant overlap of autonomic innervation between the genitourinary structures and other visceral organs, referred pain is common. The iliohypogastric, ilioinguinal, and genitofemoral nerves arise from the lower thoracic and upper lumbar segments of the spinal cord and supply cutaneous innervation to the lower abdomen and the genitalia. A number of retroperitoneal inflammatory processes, whether originating from a genitourinary organ or otherwise, may cause irritation of these nerves. Inflammatory processes may thus cause referral of pain to the lower abdominal quadrants or the genitalia. In this article, an attempt is made to present those genitourinary disease entities that are most commonly confused with non-urologic causes of the acute abdomen. Because of space limitations, a number of disease processes, such as acute renovascular events, spontaneous rupture of the bladder, and severe prostatic infections, will not be discussed. This is not to deny their importance as disease entities but rather acknowledges their infrequent presentations as acute abdominal processes. Three primary areas are included in this article: renal and perirenal infections, obstructions of the ureter and renal pelvis, and acute intrascrotal events.

UR - http://www.scopus.com/inward/record.url?scp=0023919355&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0023919355&partnerID=8YFLogxK

M3 - Article

C2 - 3279554

AN - SCOPUS:0023919355

VL - 68

SP - 399

EP - 413

JO - Surgical Clinics of North America

JF - Surgical Clinics of North America

SN - 0039-6109

IS - 2

ER -