Efficacy of Treating Abdominal Wall Pain by Local Injection

Objective: When a patient's chief complaint is lower abdominal pain, but physical and ultrasonic examinations and laboratory tests show no evidence of any noticeable disease, physicians may make a wrong diagnosis, such as abdominal adhesion, chronic pelvic inflammatory disease, pelvic congestio...

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Main Authors: Long-Ching Kuan, Yiu-Tai Li, Fu-Min Chen, Chia-Jung Tseng, Shu-Fang Wu, Tsung-Cheng Kuo
Format: Article
Language:English
Published: Elsevier 2006-09-01
Series:Taiwanese Journal of Obstetrics & Gynecology
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S1028455909602321
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spelling doaj-d4c50eb10af54366a4051c5a5c32c63b2020-11-24T23:16:17ZengElsevierTaiwanese Journal of Obstetrics & Gynecology1028-45592006-09-0145323924310.1016/S1028-4559(09)60232-1Efficacy of Treating Abdominal Wall Pain by Local InjectionLong-Ching Kuan0Yiu-Tai Li1Fu-Min Chen2Chia-Jung Tseng3Shu-Fang Wu4Tsung-Cheng Kuo5Department of Obstetrics and Gynecolog, Kuo General Hospital, Tainan, TaiwanDepartment of Obstetrics and Gynecolog, Kuo General Hospital, Tainan, TaiwanDepartment of Obstetrics and Gynecology, Chung Shan Hospital, Taipei, TaiwanDepartment of Anesthesia, Kuo General Hospital, Tainan, TaiwanDepartment of Nursing, Kuo General Hospital, Tainan, TaiwanDepartment of Nursing, Kuo General Hospital, Tainan, TaiwanObjective: When a patient's chief complaint is lower abdominal pain, but physical and ultrasonic examinations and laboratory tests show no evidence of any noticeable disease, physicians may make a wrong diagnosis, such as abdominal adhesion, chronic pelvic inflammatory disease, pelvic congestion and even psychosomatic disorders. In actuality, the pain may originate from the abdominal wall instead of the viscera. Local anesthetics coupled with steroid injections not only effectively alleviate the pain but also means that laparoscopy and medication can be avoided and is thereby worthy of wide use. Here, we present the results for the treatment of abdominal wall pain by local injection. Materials and Methods: Between January 1994 and December 2005, we treated 211 abdominal wall pain patients. Diagnoses were based on the pressure of the abdominal wall tender point, which elicited sharp shooting pain during compression, and presence of positive Carnett's sign. After confirmation of the trigger point, a fine needle was used to inject a mixture of 0.5% bupivacaine 2 mL, 2% lidocaine 3 mL and 4 mg betamethasone 1 mL. The patients were examined on a weekly basis and underwent reinjection if symptoms recurred. Results: There were 71 patients who were lost to or refused treatment or follow-up; the 140 remaining patients were evaluated. After trigger point injection in these patients, 95 (67.9%) reported no pain at all after treatment. Forty-five (32.1%) patients still had abdominal pain and required a second injection. A total of 133 (95%) patients showed complete pain resolution. After 3 months of follow-up, 115 (86.5%) patients remained free of abdominal pain. Conclusion: Local injection for selective abdominal wall pain patients produces significant pain relief. The diagnosis of abdominal wall pain is an important component in avoiding unnecessary operations in patients with abdominal pain.http://www.sciencedirect.com/science/article/pii/S1028455909602321abdominal wall paintrigger point
collection DOAJ
language English
format Article
sources DOAJ
author Long-Ching Kuan
Yiu-Tai Li
Fu-Min Chen
Chia-Jung Tseng
Shu-Fang Wu
Tsung-Cheng Kuo
spellingShingle Long-Ching Kuan
Yiu-Tai Li
Fu-Min Chen
Chia-Jung Tseng
Shu-Fang Wu
Tsung-Cheng Kuo
Efficacy of Treating Abdominal Wall Pain by Local Injection
Taiwanese Journal of Obstetrics & Gynecology
abdominal wall pain
trigger point
author_facet Long-Ching Kuan
Yiu-Tai Li
Fu-Min Chen
Chia-Jung Tseng
Shu-Fang Wu
Tsung-Cheng Kuo
author_sort Long-Ching Kuan
title Efficacy of Treating Abdominal Wall Pain by Local Injection
title_short Efficacy of Treating Abdominal Wall Pain by Local Injection
title_full Efficacy of Treating Abdominal Wall Pain by Local Injection
title_fullStr Efficacy of Treating Abdominal Wall Pain by Local Injection
title_full_unstemmed Efficacy of Treating Abdominal Wall Pain by Local Injection
title_sort efficacy of treating abdominal wall pain by local injection
publisher Elsevier
series Taiwanese Journal of Obstetrics & Gynecology
issn 1028-4559
publishDate 2006-09-01
description Objective: When a patient's chief complaint is lower abdominal pain, but physical and ultrasonic examinations and laboratory tests show no evidence of any noticeable disease, physicians may make a wrong diagnosis, such as abdominal adhesion, chronic pelvic inflammatory disease, pelvic congestion and even psychosomatic disorders. In actuality, the pain may originate from the abdominal wall instead of the viscera. Local anesthetics coupled with steroid injections not only effectively alleviate the pain but also means that laparoscopy and medication can be avoided and is thereby worthy of wide use. Here, we present the results for the treatment of abdominal wall pain by local injection. Materials and Methods: Between January 1994 and December 2005, we treated 211 abdominal wall pain patients. Diagnoses were based on the pressure of the abdominal wall tender point, which elicited sharp shooting pain during compression, and presence of positive Carnett's sign. After confirmation of the trigger point, a fine needle was used to inject a mixture of 0.5% bupivacaine 2 mL, 2% lidocaine 3 mL and 4 mg betamethasone 1 mL. The patients were examined on a weekly basis and underwent reinjection if symptoms recurred. Results: There were 71 patients who were lost to or refused treatment or follow-up; the 140 remaining patients were evaluated. After trigger point injection in these patients, 95 (67.9%) reported no pain at all after treatment. Forty-five (32.1%) patients still had abdominal pain and required a second injection. A total of 133 (95%) patients showed complete pain resolution. After 3 months of follow-up, 115 (86.5%) patients remained free of abdominal pain. Conclusion: Local injection for selective abdominal wall pain patients produces significant pain relief. The diagnosis of abdominal wall pain is an important component in avoiding unnecessary operations in patients with abdominal pain.
topic abdominal wall pain
trigger point
url http://www.sciencedirect.com/science/article/pii/S1028455909602321
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