Journal Article

Chronic Abdominal Wall Pain: A Common Yet Overlooked Etiology of Chronic Abdominal Pain

Hoversten, Patrick, Kamboj, Amrit K., Oxentenko, Amy S.

2019

Overview

Chronic abdominal wall pain is a common, yet often overlooked, cause of chronic abdominal pain in both the outpatient and inpatient settings. This disorder most commonly affects middle-aged adults and is more prevalent in women than in men. In chronic abdominal wall pain, the pain occurs due to entrapment of the cutaneous branches of the sensory nerves that supply the abdominal wall. Although the diagnosis of chronic abdominal wall pain can be made using patient history, physical examination, and response to a trigger point injection, patients often undergo extensive and exhaustive laboratory, imaging, and procedural work-up before being diagnosed with this condition, given it is often overlooked. Carnett’s sign is a specialized physical examination technique that can help support the fact that the abdominal pain originates from the abdominal wall rather than from the abdominal viscera. The mainstay of treatment consists of reassurance, activity modification, over-the-counter analgesic agent, and trigger point injection. In rare cases, treatment with chemical neurolysis or surgical neurectomy may be required.

• Publisher: Elsevier Inc,Frontline Medical Communications Inc,Elsevier Limited
• Subject: Abdomen / Abdominal pain / Abdominal wall / Analgesics / Bone surgery / Care and treatment / Causes of / Chronic pain / Compression / Diagnosis / Differential diagnosis / Dyspepsia / Edema / Endometriosis / Etiology / Etiology (Medicine) / Fibromyalgia / Fibrosis / Gastroesophageal reflux / Injection / Intestine / Irritable bowel syndrome / Medical examination / Nociceptors / Oral contraceptives / Pain / Pain perception / Patient assessment / Pregnancy / Risk factors / Sensory neurons / Spine / Surgery / Umbilicus / Womens health