Chronic abdominal pain secondary to thoracic disc hernia: a cross-sectional study of 46 patients

Lara, FJ Pérez; Carmona, José; Quesada, J. Quintero; Ramiro, JA Moreno; Toledo, R. Bustamante; Moreno, Alberto; Muñoz, H. Oliva

doi:10.13070/rs.en.1.866

Cited by 1 publication

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“…Given these premises, in two recent papers 11 , 12 , we published the results of a two-phase study in which a spinal MRI was performed on all patients attending our clinic with chronic abdominal pain and symptoms (with criteria of parietal pain, after the presence of an organic pathology had been rejected). Of these patients 63.82 % (30 of 47) were found to have one or more thoracic disc protrusions.…”

Section: Introductionmentioning

confidence: 99%

Chronic Abdominal Syndrome Due to Nervous Compression. Study of 100 Cases and Proposed Diagnostic-Therapeutic Algorithm

Lara¹,

Quesada²,

Ramiro³

et al. 2015

Journal of Gastrointestinal Surgery

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ObjectiveIn the medical literature, thoracic disc protrusion has traditionally been considered a rare occurrence. We hypothesise that the incidence of such protrusions and their abdominal symptoms is higher than is generally believed and that their presence may account for a significant proportion of chronic non-visceral abdominal pains. Accordingly, the present study was designed to identify and quantify the symptoms experienced by patients with thoracic disc protrusion and to assess the relative risk of these symptoms being presented, compared to the general population.DesignWe conducted a cross-sectional study with a control group. The following comparison groups were analysed: case group, consisting of 100 patients diagnosed with thoracic disc protrusion in our hospital between February 2007 and October 2012, and control group consisting of 100 subjects from the general population, chosen at random. To compare the symptoms observed in each group, the following tests were applied to all study subjects: clinical examination, gastrointestinal-related quality of life (GIQLI) questionnaire and DN4 questionnaire. We also reviewed the subjects’ medical records for the previous 3 years.ResultsThe subjects in the case group had a significantly higher incidence of digestive-urologic symptoms, a poorer gastrointestinal quality of life and greater need of medical care than those in the control group. The differences were statistically significant for all the parameters studied. Almost all the case group subjects suffered chronic abdominal pain and/or digestive-urologic symptoms. We term this group of symptoms “chronic abdominal syndrome due to nervous compression”. Nevertheless, in most cases, no neurologic aetiology was suspected, and therefore the treatment given was ineffective. In view of the results obtained, we propose a diagnostic-therapeutic algorithm for such patients.ConclusionThoracic disc protrusion, as well as having a non-negligible incidence, is often associated with a digestive-urologic clinical syndrome, and this factor should be taken into account in all cases of chronic abdominal pain and other digestive-urologic symptoms when standard tests are negative, so that appropriate treatment may be given.

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Section: Introductionmentioning

confidence: 99%