Abdominal wall pain

Other hypotheses include steroids acting as ‘membrane stabilizers’ or acting as ‘thin-ners’ of connective tissue around painful nerve roots. A possible explanation for this lack of difference is that the main effect may be provided by the anesthetic which is thought to break the chronic pain cycle. Alternatively, the present study may not have had […]

Greenbaum et al therefore modified the Carnett test to include additional criteria as outlined in the present paper, and it has been shown to have a sensitivity of 85% and specificity of 97%. By comparison, the Carnett test alone was 78% sensitive and 88% specific. Not surprisingly, in our study, it was the patients who […]

Each study had a slightly different patient base, different inclusion and exclusion criteria and use of the Carnett test, and different combinations of injected agents. One of the purposes of the present study was to try to determine which of these factors are important in predicting response. When faced with a patient with suspected AWP, […]

A number of treatments for AWP have been suggested. These include analgesics, topical anesthetic creams, massage, physical therapy, stretching and dry needling. One of the more widely studied treatments consists of TPI into the most tender spot. There have been a number of case reports and studies looking at short-term relief but there are very […]

Neither sex nor presence of radiation predicted response. Similarly, the addition of a steroid to local anesthetic did not alter the amount of relief obtained. One of the strongest predictors of long-term relief was whether patients met the criteria for AWP (Figure 2). As mentioned, 77% of the patients who met the criteria for AWP […]

Diagnostic procedures and costs On average, 4.3 tests were performed per patient (Table 2). This included 93 ultrasound examinations, 71 esophagogastro-duodenoscopies, 33 colonoscopies, 32 small bowel follow throughs, 30 computed tomography scans and 27 barium enemas. As well, 14 exploratory laparotomies were performed. An average of 3.3 follow-up visits were held per patient.

Of 110 consecutive patients who received TPI, 89 patients met the defined criteria for AWP. In those who met the criteria for AWP, the mean age was 42 years (range 12 to 88 years). Eighty-four per cent of the patients were female. The mean duration of the pain was 23 months (range 0.25 to 180 […]

Procedures and tests were included only if chart review disclosed that they were performed to directly evaluate the abdominal pain. Tests were excluded if they were ordered for a different reason or a different symptom. The number of initial gastroenterology consultations as well as follow-up clinic visits scheduled specifically to follow the progress of the […]

Upper GI symptoms were defined as nausea, vomiting, hematemesis, dysphagia, odynophagia, regurgitation, heartburn or waterbrash. Lower GI symptoms were defined as constipation, diarrhea, blood from the rectum, tenesmus or pain associated with a bowel movement. The presence of a scar was defined as a scar occurring in the immediate vicinity of the pain. The duration […]

We compared the outcomes in patients who met the criteria for AWP with those who did not meet the criteria. Finally, we determined whether any factors (including sex, GI symptomatology, radiation of pain, location of pain, type of injection and the presence of a scar) were predictors of response. A retrospective chart review was performed […]