next up previous index Surgical Topics
Next: Referred Pain Up: The three pains Previous: The three pains   Index

Visceral Pain

Sensation arising from the intestine is not the same as sensation arising from the skin. The gut does not need to know about the same things as the skin so it has a different repertoire.

The gut does not mind being cut or burnt. But it does not like being pulled or distended. It does not like being irritated by things that are normally not present in its lumen (c.f. gastro-esophageal reflux).

If a surgeon is doing an operation under local anesthesia such as a groin hernia. The gut will not respond at all to cutting and burning, however, pulling on the gut and its mesentry to get more out of the abdomen will be quite uncomfortable.

The nerves carrying pain impulses from the intestine travel with the blood vessels in the mesentry back to autonomic plexi around the aorta in the retro-peritoneum. Stimulation of these pain fibers results in pain being felt in the midline. The higher up in the intestine the source of pain the higher up in the midline anteriorly the pain is felt. Visceral pain is usually described as coming 'from inside' and the patient knows it is not coming from the skin. It may be dull, boring and crampy.


next up previous index Surgical Topics
Next: Referred Pain Up: The three pains Previous: The three pains   Index
Adrian P. Ireland