If you had bad abdominal pain shooting through to the back, I would tell you to go to the Emergency immediately. What condition am I worried about that kills 9 of 10 people?
What we worry about: Abdominal aortic aneurysm (AAA) rupture.
Your aorta is your body’s main “plumbing”–the big blood vessel that carries blood from your heart to the rest of your body. Sometimes it starts to rip apart and cut through the layers of tissue that normally contain all that blood under high pressure. An AAA rupture occurs when the abdominal section of the aorta tears open. These usually occur after age 50. The pain is usually felt from the middle of the belly and radiates through to the middle of the back (and not just one side, like with kidney stones, typically).
Like a ticking time-bomb, the aneurysm itself is usually silent and slow growing, until it’s so big that the bomb goes off. Normally your aorta would measure about 3 cm across. As it bulges over 5 cm, the risk of sudden rupture and death by internal bleeding increases. Once it ruptures, the risk of dying from it may be as high as 90%!
If the emergency doctor can diagnose these early, patients can sometimes make it in time for emergency surgery or other treatments.
BEWARE of sudden, very severe pain in the front of the chest or abdomen that shoots through to the middle of the back. The pain is usually constant and doesn’t get better or worse with movement, rest, position, activity, meals, or breathing and even narcotic medications like morphine may not help.
This is an excerpt from PART 4: ARMCHAIR EMERG DOC in a section called “Time-sensitive Conditions” where I share things that things Emergency Physicians think and worry about, even in people who may not look very sick at first. These can be critical, life or limb-threatening, especially if diagnosed late.
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