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Visceral
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1. Mechanical obstruction of hollow viscera
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a. Obstruction of the small or large intestine
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b. Obstruction of the biliary tree
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c. Obstruction of the ureter
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2. Distention of visceral surfaces, eg, hepatic or renal capsules
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3. Vascular disturbances
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a. Embolism or thrombosis
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b. Vascular rupture
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c. Pressure or torsional occlusion
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d. Sickle cell anemia
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4. Referred from non-abdominal viscera
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a. Thorax, eg, pneumonia, referred pain from coronary occlusion
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5. Metabolic causes
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a. Black widow spider bite
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b. Lead poisoning and others
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c. Uremia
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b. Diabetic ketoacidosis
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c. Porphyria
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d. Allergic factors (C'1 esterase inhibitor deficiency)
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Somatic
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1. Parietal peritoneal inflammation
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a. Bacterial contamination, eg, perforated appendix, pelvic inflammatory disease
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b. Chemical irritation, eg, perforated ulcer, pancreatitis, mittelschmerz
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2. Abdominal wall
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a. Distortion or traction of mesentery
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b. Trauma or infection of muscles
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3. Spine, eg, radiculitis from arthritis
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4. Neurogenic causes
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a. Tabes dorsalis
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b. Herpes zoster
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c. Causalgia and others
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d. Functional
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