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What is Initial periumbilical pain shifting to right iliac fossa is symptoms suggestive of and explain in detail?
In acute appendicitis, visceral pain stas around the umbilicus d/t distension of appendix, later after few hours somatic pain occurs in the right iliac fossa d/t irritation of parietal peritoneum by inflamed appendix.In mesenteric ischemia, abdominal pain is out of propoion in relation to tenderness; pain is around umbilicus to begin with which later becomes diffuse. Right ureteric colic pain is colicky in type and radiates from right loin to groin often to the tip of genitalia, testis in males, labia majora in females.The abdomen is moderately-to-severely tender in a diffuse or localized pattern, usually on the right side in case of abdominal worms. Reference : page 940, 871, 1019SRB's manual of surgery 5th edition