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Chronic abdominal wall pain

Diagnostic validity and costs

  • Intestinal Disorders, Inflammatery Bowel Disease, Immunology, And Microbiology
  • Published:
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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 ≥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.

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Greenbaum, D.S., Greenbaum, R.B., Joseph, J.G. et al. Chronic abdominal wall pain. Digest Dis Sci 39, 1935–1941 (1994). https://doi.org/10.1007/BF02088128

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  • DOI: https://doi.org/10.1007/BF02088128

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