Related Experiment Videos
Chronic abdominal wall pain. Diagnostic validity and costs
D S Greenbaum1, R B Greenbaum, J G Joseph
1Michigan State University, Department of Medicine, East Lansing 48824-1315.
Digestive Diseases and Sciences
|September 1, 1994
Summary
Chronic abdominal wall pain (CAWP) is often misdiagnosed as visceral pain. This study confirms CAWP is typically stable and treatable with injections, reducing unnecessary diagnostic costs.
Area of Science:
- Gastroenterology
- Pain Management
- Abdominal Pain Syndromes
Background:
- Chronic abdominal wall pain (CAWP) is a prevalent condition frequently misdiagnosed as visceral pain.
- Accurate diagnosis of CAWP is crucial to avoid extensive and costly investigations for visceral pathologies.
Purpose of the Study:
- To assess the diagnostic stability and treatment efficacy of chronic abdominal wall pain.
- To evaluate the long-term pain relief and cost-effectiveness of diagnosing and managing CAWP.
Main Methods:
- Seventy-nine patients with suspected CAWP underwent diagnostic local anesthetic-corticosteroid injections.
- Pain intensity changes, duration of relief (≥3 months), and recurrence rates were monitored.
- Diagnostic costs for excluding visceral causes in confirmed CAWP patients were analyzed.
Main Results:
- 91% of patients (72/79) achieved ≥50% pain relief post-injection, confirming CAWP diagnosis.
- Only 4 patients were later diagnosed with visceral disease; CAWP was confirmed in 56 of the remaining 68.
- Diagnostic procedures to rule out visceral causes cost approximately $700 per patient with confirmed CAWP.
Conclusions:
- Chronic abdominal wall pain is a distinct entity, usually stable and effectively managed with anesthetic-corticosteroid injections.
- Increased clinical awareness and prompt diagnosis of CAWP can significantly minimize misdiagnosis and reduce healthcare costs.
- Targeted treatment for CAWP offers substantial pain relief and avoids unnecessary investigations for visceral pain.