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Twelfth-rib syndrome simulating intra-abdominal disease. Case report
P Jalovaara1, J Rämö, R Lindholm
1Department of Surgery, Oulu University Hospital, Finland.
Acta Chirurgica Scandinavica
|May 1, 1988
Summary
Bilateral intercostal neuralgia causing widespread pain was successfully treated by resecting the 11th and 12th ribs. This surgical intervention offers a novel approach for chronic abdominal pain management.
Area of Science:
- Neurology
- Surgical Anatomy
Background:
- Chronic abdominal pain presents a diagnostic challenge, often requiring extensive differential diagnosis.
- Intercostal neuralgia, particularly bilateral, is an under-recognized cause of referred pain to the abdomen and lower extremities.
Observation:
- A patient presented with a distinct syndrome of bilateral intercostal neuralgia.
- Pain radiated to the loin, lower abdomen, groin, and thigh, mimicking other abdominal pathologies.
Findings:
- Surgical resection of the 11th and 12th ribs provided a complete cure for the patient's symptoms.
- The study elucidates the complex pain referral pathways involved in this specific neuralgia.
Implications:
- This case highlights the importance of considering intercostal neuralgia in the differential diagnosis of chronic abdominal pain.
- Resection of specific ribs may be an effective treatment for refractory cases of this pain syndrome.