Postoperative Abdominal Wall Pain

2018 ◽  
Author(s):  
Dan Dirzu ◽  
Ovidiu Palea ◽  
Sarah Choxi
Keyword(s):  
Abdominal Pain ◽  
Abdominal Wall ◽  
Trigger Point ◽  
Bowel Function ◽  
The United States ◽  
Office Visits ◽  
Abdominal Wall Pain ◽  
Refractory Pain ◽  
Carnett’S Sign ◽  
Pain Generator

Abdominal pain accounts for almost 1.5% of office visits and nearly 5% of emergency department admissions each year in the United States. In 2% to 3% of patients with chronic abdominal pain, the pain arises from the abdominal wall. Postoperative abdominal wall pain is chronic, unremitting pain unaffected by eating or bowel function but exacerbated by postural change. A localized, tender trigger point can be identified, although pain may radiate over a diffuse area of the abdomen. Thorough history and physical examination can distinguish abdominal wall pain from visceral intra-abdominal pain. A positive Carnett’s sign favors an abdominal wall pain generator and not a visceral source. Injection with a local anesthetic and steroid at the area of pain may provide relief and can function also as a diagnostic test for abdominal wall pain. Refractory pain may be treated with chemical neurolysis, radiofrequency ablation, peripheral nerve stimulators, or neurectomy.

scholarly journals Long-term Follow-up of Trigger Point Injections for Abdominal Wall Pain

2005 ◽  
Vol 19 (9) ◽  
pp. 561-565 ◽  
Author(s):  
Jose Nazareno ◽  
Terry Ponich ◽  
Jamie Gregor
Keyword(s):  
Abdominal Pain ◽  
Abdominal Wall ◽  
Diagnostic Tests ◽  
Primary Outcome ◽  
Trigger Point ◽  
Long Term Outcome ◽  
Abdominal Wall Pain ◽  
Secondary Analyses

OBJECTIVE: Abdominal wall pain (AWP) is a common yet often overlooked source of abdominal pain. Trigger point injections (TPI) into the abdominal wall have been tried in the past. Few studies have looked at the long-term outcome from these injections.METHODS: A retrospective chart review was performed on 110 consecutive patients who received TPI for abdominal pain at the University of Western Ontario, London, Ontario. Outcomes from patients whose pain was due to AWP were determined. AWP was defined as fixed or localized pain and superficial or point tenderness (less than 2.5 cm diameter) or a positive Carnett sign (increased pain with tensing abdomen). The primary outcome was long-term efficacy of TPI. The number of diagnostic tests ordered to exclude AWP and the cost of investigating it were determined. Secondary analyses were done to determine if there were significant predictors of response to TPI.RESULTS: Eighty-nine of 110 patients who received TPI met the criteria for AWP. In those who met the criteria for AWP, the average age was 42 years, 84% were female, and the average length of follow-up was 25 months. The primary outcome shows that, at follow-up, 77% had some or complete relief and 23% had no relief. An average of 4.3 diagnostic tests per patient were ordered to exclude other causes of abdominal pain. Secondary analyses show that meeting the criteria for AWP ( P<0.0005), the absence of gastrointestinal symptoms ( P<0.025), and an upper abdominal location of pain ( P<0.025) were statistically significant predictors of a positive response to TPI.CONCLUSIONS: This study demonstrates that TPI, in patients who meet criteria for AWP, are effective over the long term.

scholarly journals The Easiest Abdominal Pain Patient: Addressing Abdominal Wall Pain

2021 ◽  
Author(s):  
Jeffrey T. Laczek ◽  
Caleb Hudspath ◽  
Manish Singla
Keyword(s):  
Abdominal Pain ◽  
Abdominal Wall ◽  
Pain Patient ◽  
Abdominal Wall Pain

Ultrasound-guided transversus abdominis plane block vs trigger point injections for chronic abdominal wall pain

Pain ◽  
2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Susan M. Moeschler ◽  
E. Morgan Pollard ◽  
Matthew J. Pingree ◽  
Thomas P. Pittelkow ◽  
Mark A. Bendel ◽  
...  
Keyword(s):  
Abdominal Wall ◽  
Trigger Point ◽  
Transversus Abdominis Plane Block ◽  
Transversus Abdominis ◽  
Transversus Abdominis Plane ◽  
Ultrasound Guided ◽  
Abdominal Wall Pain ◽  
Chronic Abdominal Wall Pain

scholarly journals Su1586 - Prevalence of Anterior Abdominal Wall Pain in Patients Presenting to a Neurogastroenterology Clinic with Unexplained Chronic Abdominal Pain

2018 ◽  
Vol 154 (6) ◽  
pp. S-537
Author(s):  
Ron Fried ◽  
Ahmed Albusoda ◽  
Asma Fikree ◽  
Adam D. Farmer ◽  
Jayne Gallagher ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Abdominal Wall ◽  
Anterior Abdominal Wall ◽  
Chronic Abdominal Pain ◽  
Abdominal Wall Pain

scholarly journals CHRONIC NON-CANCER ABDOMINAL WALL PAIN AMELIORATION VIA PHENOL NEUROLYSIS BY TRANVERSUS ABDOMINIS PLANE APPROACH: A CASE REPORT

2019 ◽  
pp. 127-130
Author(s):  
Heath McAnally
Keyword(s):  
Abdominal Pain ◽  
Case Report ◽  
Abdominal Wall ◽  
Anterior Abdominal Wall ◽  
Case Reports ◽  
Tap Block ◽  
Abdominal Wall Pain ◽  
Chemical Denervation ◽  
Chronic Abdominal Wall Pain ◽  
Noncancer Pain

Abdominal pain is common and has multiple etiologies. We present a case of chronic abdominal wall pain that was treated with phenol neurolysis via a tranversus abdominis plane (TAP). To date, only 4 case reports utilizing TAP neurolysis have been reported and all were performed in the context of malignancy-related pain. The TAP block has become an integral component of the regional anesthesiologist’s perioperative anesthesia and analgesia arsenal. In summary, chemical denervation of the anterior abdominal wall is feasible and efficacious in palliating chronic non-cancer pain via a TAP block technique. Key words: TAP, transversus abdominal plane, phenol, abdominal wall pain, neurolytic, noncancer pain

Misdiagnosis of anterior cutaneous nerve entrapment syndrome as a somatization disorder

2016 ◽  
Vol 33 (S1) ◽  
pp. S387-S388 ◽  
Author(s):  
M. Arts ◽  
J. Buis ◽  
L. de Jonge
Keyword(s):  
Abdominal Pain ◽  
Depressive Symptoms ◽  
Abdominal Wall ◽  
Nerve Entrapment ◽  
Cutaneous Nerve ◽  
Somatization Disorder ◽  
Abdominal Wall Pain ◽  
Chronic Abdominal Wall Pain ◽  
Nerve Entrapment Syndrome

IntroductionAnterior cutaneous nerve entrapment syndrome (ACNES) is a frequently overlooked disease, causing chronic abdominal wall pain due to entrapment of an anterior cutaneous branch of one or more thoracic intercostal nerves. It is often misdiagnosed as a psychiatric condition, particularly under the heading of a somatization disorder.ObjectivesWe describe the case of a patient who developed depressive symptoms after months of suffering from chronic abdominal wall pain.AimsTo report a case-study, describing ACNES as a cause of persistent depressive symptoms.MethodsA case-study is presented and discussed, followed by a literature review.ResultsA 35-year-female was referred to a psychiatrist for her depressive symptoms and persistent cutaneous abdominal pain for months. There she was diagnosed with a depression and possible somatization disorder and she received psychotherapy. Through Internet search, the patient found ACNES as a possible cause for her persistent abdominal pain. Since administration of anesthetic agents only shortly relieved her symptoms, a surgeon decided to remove the nerve end twigs. After surgery, her somatic problems and depressive mood disappeared.ConclusionThe awareness of ACNES is still very limited in medicine. This may lead to incorrect diagnoses, including psychiatric disorders such as somatization disorder.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Outcomes of Ultrasound-Guided Trigger Point Injection for Abdominal Wall Pain

2015 ◽  
Vol 61 (2) ◽  
pp. 572-577 ◽  
Author(s):  
Mhd Firas Alnahhas ◽  
Shawn C. Oxentenko ◽  
G. Richard Locke ◽  
Stephanie Hansel ◽  
Cathy D. Schleck ◽  
...  
Keyword(s):  
Abdominal Wall ◽  
Trigger Point ◽  
Ultrasound Guided ◽  
Abdominal Wall Pain ◽  
Point Injection

scholarly journals Chronic Abdominal Wall Pain Misdiagnosed as Functional Abdominal Pain

2013 ◽  
Vol 26 (6) ◽  
pp. 738-744 ◽  
Author(s):  
T. van Assen ◽  
J. W. A. J. de Jager-Kievit ◽  
M. R. Scheltinga ◽  
R. M. H. Roumen
Keyword(s):  
Abdominal Pain ◽  
Abdominal Wall ◽  
Functional Abdominal Pain ◽  
Abdominal Wall Pain ◽  
Chronic Abdominal Wall Pain

scholarly journals Recognition and Treatment of Abdominal Wall Pain

1989 ◽  
Vol 82 (6) ◽  
pp. 343-344 ◽  
Author(s):  
N C Gallegos ◽  
M Hobsley
Keyword(s):  
Abdominal Pain ◽  
Abdominal Wall ◽  
Local Anaesthetic ◽  
Simple Test ◽  
Abdominal Wall Pain

In some patients with abdominal pain, the source of the pain may be the abdominal wall. A simple test is described which allows these patients to be identified and treated with injections of local anaesthetic and steroid. Twenty-six patients were studied, 20 of whom were available for follow-up. Sixteen of these 20 were symptom free or improved at a median follow-up period of 29 months. Failure to recognize abdominal wall pain may lead to unnecessary investigation.

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