rss
BMJ Case Reports 2009; doi:10.1136/bcr.07.2008.0482
  • Reminder of important clinical lesson

Abdominal wall pain in obese women: frequently missed and easily treated

  1. Yehia Yousri Mishriki
  1. Lehigh Valley Hospital, Medicine, Suite 3600, 1210 South Cedar Crest Blvd, Allentown, PA 18104, USA
  1. Yehia.Mishriki{at}lvh.com
  • Published 27 February 2009

Summary

Chronic abdominal pain is a common symptom with an extensive differential diagnosis. The work-up is frequently costly, yet many patients elude definitive diagnosis. We describe 12 obese women with long-standing abdominal pain, many of whom eluded diagnosis but who met criteria for abdominal wall pain. Each patient underwent a focused history and physical examination which included checking for Carnett’s sign and performing a “pinch test”. All patients had positive Carnett’s sign and pinch tests. An injection of local anaesthetic, with or without corticosteroid, completely relieved the pain within 10 min. Of the six patients seen in follow-up, four remained pain free and two responded to a second injection of local anaesthetic. Abdominal wall pain is an under-appreciated cause of chronic abdominal pain. Diagnosis is often straightforward and treatment with a local injection of anaesthetic is both diagnostic and curative.

Footnotes

  • Competing interests: none.

Register for free content

The full text of all Editor's Choice articles and summaries of every article are free without registration

The full text of Images in ... articles are free to registered users

Only fellows can access the full text of case reports (apart from Editor's Choice) - become a fellow today, or encourage your institution to, so that together we can grow and develop this resource

Don't forget to sign up for content alerts so you keep up to date with all the case reports as they are published, and let us know what you think by commenting on the Editor's blog

Navigate This Article