Abdominal pain: Tabes dorsalis crisis
This is a pulling pain from the anus all the way up to either left or right upper quadrant. The pain is severe and feels like a lightening in quality. It is from the damaged spinal cord and inflamed meninges from tertiary syphilis. Pain can be treated with carbamazepine or gabapentin. Look at their pupils. There may be a unique abnormal finding.
Successful treatment of tabetic lightning pain and visceral crisis with gabapentin. Kyoko Oshita, et al. J Anesth. 2011 Dec; 25(6): 952.
Abdominal pain: syphilis visceral crisis
In another 3 weeks, her legs became numb and her left leg was weak.
Syphilitic meningomyelitis presenting with visceral crisis. Li Sun, MD, PhD. et al. Medicine (Baltimore). 2018 Jul; 97(30): e11661.