Chronic abdominal wall pain. Diagnostic validity and costs.

Abstract:

:Chronic abdominal wall pain (CAWP) is common and frequently mistaken for visceral pain. We determined the stability of this diagnosis with Main Outcome Measures of: (a) change of pain intensity after local anesthetic-corticosteroid injection, (b) pain relief after three or more months follow-up, and (c) costs of diagnostic procedures for visceral causes of abdominal pain in patients with confirmed CAWP. Seventy-nine patients fulfilled tentative criteria for CAWP; 72 (91%) experienced > or = 50% pain relief with anesthetic injection and were followed for at least three months (mean = 13.8 months). Abdominal pain in four patients was later diagnosed as caused by visceral disease. CAWP was confirmed in 56 of remaining 68 patients; 12 of 19 patients with recurrent pain were unavailable for re-injection of anesthetic. Thirty patients with confirmed CAWP had had diagnostic procedures to exclude visceral disease costing almost $700 per patient. CAWP is usually easily identified and treated; greater awareness should minimize misdiagnosis.

journal_name

Dig Dis Sci

authors

Greenbaum DS,Greenbaum RB,Joseph JG,Natale JE

doi

10.1007/BF02088128

subject

Has Abstract

pub_date

1994-09-01 00:00:00

pages

1935-41

issue

9

eissn

0163-2116

issn

1573-2568

journal_volume

39

pub_type

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