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Chronic abdominal pain caused by thoracic disc herniation
D C Whitcomb1, S P Martin, R E Schoen
1Department of Medicine, University of Pittsburgh, Pennsylvania, USA.
The American Journal of Gastroenterology
|May 1, 1995
Summary
A herniated thoracic disc mimicked chronic pancreatitis pain in a patient. Surgical discectomy resolved the severe abdominal pain, highlighting the importance of considering spinal conditions in abdominal pain diagnosis.
Area of Science:
- Neurosurgery
- Gastroenterology
- Pain Management
Background:
- A patient presented with a 7-year history of severe, disabling chronic epigastric abdominal pain attributed to chronic pancreatitis.
- Despite extensive prior interventions including surgery and intrathecal morphine, pain control remained poor.
Observation:
- A focused physical examination suggested thoracic disc disease.
- Myelogram with computed tomography confirmed a T7-T8 disc disruption with spinal cord compression and a bone spur.
Findings:
- Microsurgical thoracic discectomy was performed.
- The patient experienced immediate pain resolution and was medication-free within weeks.
Implications:
- This case represents the first reported instance of a herniated thoracic disc presenting as chronic pancreatitis pain.
- Thoracic disc syndrome should be considered in the differential diagnosis of chronic abdominal pain, even in patients with a history of pancreatic disease.