Chronic abdominal wall pain - Diagnostic validity and costs

David S. Greenbaum, Ruth B. Greenbaum, Jill G Joseph, JoAnne E Natale

Research output: Contribution to journalArticlepeer-review

51 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)1935-1941
Number of pages7
JournalDigestive Diseases and Sciences
Volume39
Issue number9
DOIs
StatePublished - Sep 1994
Externally publishedYes

Keywords

  • anesthetic-corticosteroid injection
  • chronic abdominal wall pain
  • visceral causes of CAWP

ASJC Scopus subject areas

  • Gastroenterology

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