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Low back pain caused by a duodenal ulcer
D J Weiss1, T Conliffe, N Tata
1Schwab Rehabilitation Hospital & Care Network, Chicago, IL 60608, USA.
Archives of Physical Medicine and Rehabilitation
|September 28, 1998
Summary
A duodenal ulcer can cause low back pain, presenting as referred visceral pain. This case highlights the importance of considering uncommon gastrointestinal causes in back pain differential diagnoses.
Area of Science:
- Gastroenterology
- Pain Management
- Internal Medicine
Background:
- Low back pain has common diagnoses like lumbar strain and degenerative disc disease.
- Uncommon causes include abdominal aortic aneurysms and pelvic neoplasms.
- This report focuses on a rare cause: referred visceral pain from a duodenal ulcer.
Observation:
- A 54-year-old man presented with mid to low back pain (T10-L2).
- Initial diagnosis was joint dysfunction, with a treatment plan initiated.
- The patient later experienced syncope and coffee-ground emesis, indicating a gastrointestinal bleed.
Findings:
- Esophagogastroduodenoscopy revealed a large duodenal ulcer.
- The patient underwent vagotomy and pyloroplasty for the upper gastrointestinal bleed.
- Post-treatment, his back pain significantly improved, confirming the ulcer as the source.
Implications:
- This case underscores the necessity of including rare visceral causes in the differential diagnosis of low back pain.
- Physicians should consider gastrointestinal pathology when evaluating persistent or unusual back pain.
- Broadening diagnostic considerations can lead to timely and accurate patient management.