Pathophysiology True Visceral Pain

Because the viscera have bilateral afferent supply, true visceral pain is often felt midline. Visceral organs not supplied by afferents bilaterally are the cecum, ascending colon, appendix, descending and sigmoid colon, kidneys, and ureters, whose innervation is unilateral or predominantly unilateral. Low density of sensory innervation to the viscera along with divergence of visceral input from the central nervous system results in poor localization and diffuse nature of visceral pain. The non-specificity of a visceral sensation is caused by the CNS viscerovisceral convergence.

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