Thoracic Disk Herniation, a not Infrequent Cause of Chronic Abdominal Pain

Lara, Francisco Javier Pérez; Berges, Arminda Ferrer; Quesada, J. Quintero; Ramiro, Josefa; Toledo, R. Bustamante; Muñoz, H. Oliva

doi:10.9738/cc98.1

Cited by 18 publications

(22 citation statements)

References 18 publications

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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%

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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“…We can also suggest that thoracic intervertebral disc herniation may remain a missed diagnosis, if it is not considered within the range of preliminary diagnoses in cases with dorsalgia. [16][17][18][19][20] In conclusion, several conclusions may be made regarding the MRI findings in patients with dorsalgia. Magnetic resonance imaging is a precise imaging technique for investigating patients with complaint of dorsalgia.…”

Section: Discussionmentioning

confidence: 96%

The incidence and most common levels of thoracic degenerative disc pathologies

Sarsilmaz

Yencilek

Özelçi

et al. 2018

Turk J Phys Med Rehab

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Objectives: In this study, we aimed to describe and characterize the incidence of thoracic degenerative disc pathologies, bulging/herniation, and the most common affected levels. Patients and methods: Between January 2008 and May 2012, a total of 195 patients (109 females, 86 males; mean age 43.5 years; range, 15 to 74 years) who were admitted with the complaint of dorsalgia and underwent magnetic resonance imaging (MRI) of the thoracic vertebral column were included in the study. Data including MRI findings, endplate and disc degeneration, disc height loss, bulging, and disc herniation were retrospectively analyzed. Results: Of 3,348 patients, 195 patients had disc bulging/herniation. When 12 levels in 195 cases were taken into consideration, disc pathologies were found in 412 (18%) levels among the total of 2,340 intervertebral disc levels. Bulging was present in 11% (244/2,340) of the levels. Disc herniation was present in 7% (168/2,340) of the levels. The most commonly affected site was T 7-8 , followed by T 8-9 and T 11-12. Conclusion: Thoracic disc pathologies are still a significant diagnostic challenge. Our study results show that the incidence of these pathologies is higher than expected.

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“…One previous study pointed out that 18 out of 27 patients with chronic abdominal pain showed evidence of thoracic disc herniation in MRI as a reason for pain. Majority of these patients were previously diagnosed to have IBS [20]. MRI adds significant specificity in the diagnosis of these patients.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Potential of Magnetic Resonance Imaging in Chronic Abdominal Pain

et al. 2019

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Introduction: About half of the adult patients suffering from chronic abdominal pain may have no organ-related cause. Our purpose was to evaluate the additional information of magnetic resonance imaging (MRI) in diagnosing the underlying organic causes of such pain. Methods: We performed retrospective audit of 636 consecutive abdominal MRI in patients suffering from nonspecific abdominal pain (NSAP) during years 2014-2017. Medical history, clinical examination, endoscopy reports, and the results of MRI were compared in all patients. The hypothesis was that MRI increases markedly the diagnostic specificity of patients' symptoms. Results: The mean age of patients was 66 ± 14 years and 60 percent were females. Duration of abdominal pain ranged from 1 month to 30 years (median 1.1 ± 4.0 years). Concurrently with abdominal MRI (n = 636), also ultrasound (n = 106, 17%), colonoscopy (n = 222, 35%), and gastroscopy (n = 217, 34%) were performed. Abdominal MRI revealed additional information in 161/636 (25%) of NSAP patients. Spinal and pelvic bone abnormalities (n = 107) and malignant tumors (n = 31) were the most significant organ-specific findings changing the treatment algorithm. Conclusions: When computerized tomography is not available in outpatient clinics, abdominal MRI increases markedly diagnostic specificity and alters the treatment in 1 of 4 patients suffering from NSAP. Abdominal MRI is therefore suggested for patients suffering from severe symptoms of NSAP.

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Thoracic Disk Herniation, a not Infrequent Cause of Chronic Abdominal Pain

Cited by 18 publications

References 18 publications

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

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

The incidence and most common levels of thoracic degenerative disc pathologies

Diagnostic Potential of Magnetic Resonance Imaging in Chronic Abdominal Pain

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