How is vomiting associated with abdominal pain?

● Stimulation of afferant C fibers which go all the way to the vomitingcenters of the medulla and from there the efferent fibers innervate theintestine, causing a decrease in peristalsis which causes ileus or aggravation of peristaltis which causes vomiting. ● The pain of acute surgical abdomen mainly precedes vomiting, so patients feel acute pain followed by nausea and vomiting. However, in medical causes (non-abdominal), patients feel nausea and they vomit before the pain. ● We also need to check for blood in vomit which can be caused by a high digestive hemorrhage due to ulcers or esophageal varices (because of liver cirrhosis)... ● Check for bile as well: If no bile then we need to think of pyloric stenosis or gastric outlet obstruction or occlusion of biliary duct