What causes lower abdominal cramps?

Lower abdominal cramps can make people very uncomfortable, so many people think it is appendicitis when they experience this condition. This is indeed the most common cause of the disease, but there are other reasons that can cause lower abdominal cramps. Patients need to fully understand their own symptoms before making a conclusion to help doctors treat them and quickly recover their health.

1. Corpus luteum:

The ovary forms a corpus luteum after ovulation. The diameter of a normal mature corpus luteum is 2 to 3 cm. If there is a large amount of fluid accumulation in the corpus luteum cavity, the diameter of the cavity will exceed 3 cm.

2. The reasons why the corpus luteum is prone to rupture are:

A. Rupture due to excessive spontaneous bleeding and increased pressure in the corpus luteum;

B. Excessive exercise or strenuous labor (including sexual intercourse), or external force hitting the abdomen, which causes a sudden increase in intra-abdominal pressure and ruptures the mature corpus luteum;

C. Severe coughing or exerting too much force to treat constipation can also cause the corpus luteum to rupture.

3. Occurrence time:

Generally, it occurs on the 20th to 27th day of the menstrual cycle (premenstrual period); occasionally during menstruation and early pregnancy; clinical manifestations: sudden lower abdominal pain, nausea, vomiting, and frequent urination and defecation. In mild cases, there is little bleeding and the disease can heal on its own; in severe cases, there may be symptoms of shock such as dry mouth, palpitations, dizziness, blurred vision, etc., which require emergency surgical treatment.

4. Differential diagnosis

Ectopic pregnancy, appendicitis: Statistics show that the preoperative misdiagnosis rate can reach 20% to 40%; the main reason for misdiagnosis is false positive urine HCG, which reminds us that we should pay attention to the relationship between the time of abdominal pain and menstruation and whether there are any inducements during diagnosis. If there is a history of onset after sexual intercourse, the possibility is greater.

5. Key points for identification:

Most patients with this disease have no history of amenorrhea and often suffer from abdominal pain after sexual intercourse. The internal bleeding is less than that of ectopic pregnancy, and syncope and shock are less likely to occur. Negative blood or urine HCG is of great value in the diagnosis of this disease. During the operation, the ovary was ruptured and bleeding, and corpus luteum tissue was visible.

Physical examination: In mild cases, there is only mild tenderness in the lower abdomen. In cases where the disease occurs on the right side, the tenderness point is located lower and inside McBurney's point. In severe cases, there is obvious tenderness in the lower abdomen and rebound pain, but the abdominal muscle rigidity is not as good as in generalized peritonitis.

Bimanual examination: cervical lifting pain, tenderness in the fornix on both sides, uterus of normal size, pain when moving the uterus, fullness in the adnexal area or posterior fornix can be felt when internal bleeding is heavy, and enlarged ovaries can sometimes be palpated.

6. Treatment methods

If a tumor rupture is suspected, laparotomy/laparoscopy should be performed immediately. During the operation, the cystic fluid should be aspirated as much as possible, and smears should be taken for cytological examination. The pelvic and abdominal cavities should be cleaned, and the specimens should be carefully observed with the naked eye. Special attention should be paid to whether there is any suspicious malignant transformation at the edge of the tumor rupture, and the specimens should be sent for pathological examination.