Diabetes mellitus (DM), chronic renal failure (CRF), amyloidosis, sickle cell
anemia (SCA) and acute intermittent porphyria are among diseases that can be
associated with abdominal pain (AP) at some point in the course of the pathological
process. Diabetic ketoacidosis (DKA) is a severe life-threatening syndrome
characterized by fluid loss, electrolyte changes, hyperosmolarity and acidosis. These
pathophysiologic factors can explain AP in patients with DKA. Vomiting and AP can
also be initial manifestations of DKA even in euglycemic patients.
SCA is one of the most common autosomal recessive diseases classified in
hemoglobinopathies. The disease is first recognized by history, then by peripheral
smear and hemoglobin electrophoresis, and advanced studies. Splenic sequestration
crisis is a severe complication of SCA that prompts emergent treatment, Opiate
analgesia and hydration is the main treatment.
Patients with chronic renal failure (CRF) and end-stage renal disease are also prone to
severe AP due to peritonitis which is triggered by continuous ambulatory peritoneal
dialysis in vulnerable patients. Amyloidosis is mostly recognized with typical attacks
i.e., febrile episodes, exanthema, AP, myalgias and arthralgias.
Acute intermittent porphyria is an autosomal dominant disorder characterized by severe
neurovisceral attacks of AP, nausea, vomiting, tachycardia, and hypertension in the
absence of signs compatible with peritonitis. Management of mild attacks comprises
symptomatic treatment, optimized calorie intake, and fluid replacement to beware
dehydration.
Keywords: Abdominal pain, Acute intermittent porphyria, Amyloidosis, Chronic renal failure, Diabetes mellitus, Peritonitis, Porphyria, Sickle cell anemia, Splenic sequestration crisis.
