• Am. J. Surg. · Jul 2009

    Review

    Chronic abdominal wall pain--a diagnostic challenge for the surgeon.

    • Rolv-Ole Lindsetmo and Jonah Stulberg.
    • Department of Gastrointestinal Surgery, University Hospital of North Norway, Tromsø, Norway. rolv.ole.lindsetmo@unn.no
    • Am. J. Surg. 2009 Jul 1;198(1):129-34.

    BackgroundChronic abdominal wall pain (CAWP) occurs in about 30% of all patients presenting with chronic abdominal pain.MethodsThe authors review the literature identified in a PubMed search regarding the abdominal wall as the origin of chronic abdominal pain.ResultsCAWP is frequently misinterpreted as visceral or functional abdominal pain. Misdiagnosis often leads to a variety of investigational procedures and even abdominal operations with negative results. With a simple clinical test (Carnett's test), >90% of patients with CAWP can be recognized, without risk for missing intra-abdominal pathology.ConclusionThe condition can be confirmed when the injection of local anesthetics in the trigger point(s) relieves the pain. A fasciotomy in the anterior abdominal rectus muscle sheath through the nerve foramina of the affected branch of one of the anterior intercostal nerves heals the pain.

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