Evaluating patients with abdominal pain originating in the abdominal wall / 대한내과학회지

ABSTRACT

BACKGROUND/AIMS: We analyzed patients with abdominal pain of undetermined etiology, referred to physiatrists by gastroenterologists, and determined the clinical features of patients with abdominal wall pain. METHODS: A retrospective chart review of 100 patients referred by gastroenterologists over 4 years was performed. A visceral etiology of abdominal pain was excluded by the gastroenterology work-up using radiologic and endoscopic studies, and medical treatment. The clinical features and outcomes of abdominal wall pain were examined. We determined the long-term outcome by telephone. RESULTS: Of 100 patients with abdominal pain of undetermined etiology, 89% of the patients were identified as having pain arising in the abdominal wall, and the right flank area was the most common site of pain. The pain had a musculoskeletal origin in 90.4% of the patients and a neurogenic origin in 9.6%. Treatment by the physiatrists resulted in complete or partial pain relief in 73% of the patients. The diagnosis remained unchanged after a mean of 22.67 (range 6.5-55) months in 95.5% of the patients. Long-term effects of management were seen in 73.6% of the patients. CONCLUSIONS: In a small group of patients with abdominal pain of unknown etiology, the source of pain could be in the abdominal wall. Recognizing abdominal wall pain could lead to an accurate diagnosis, reduced medical costs and effective treatment.