진단되지 않은 채 만성 복통으로 3년 간 고통받은 장요근의 근막동통증후군 1예
A Case of Myofascial Pain Syndrome of the Iliopsoas Muscle Undiagnosed for 3 Years with Chronic Abdominal Pain
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
복통은 일차 진료에서 가장 흔히 접하는 증상 중의 하나이며 복통으로 내원하는 환자는 전체 환자의 5-6%를 차지한다. 복통을 호소하는 환자의 문제는 일과성이고 가벼운 질환일 수도 있으나 중증 질환일 수도 있으므로 복통 환자 진료는 항상 세심한 병력 청취와 진찰을 필요로 한다. 흔히 보게 되는 복통의 원인으로는 노인의 경우 비특이적인 복통, 기능성 질환, 변비, 신장 결석, 요로감염, 염증성 장질환, 담관계 질환, 급성 충수염, 게실염, 복부 대동맥류, 소화궤양, 장폐색, 장간막 허혈, 악성종양, 위장관염 등이 원인이 될 수 있으며 복벽의 근막통증이 원인이 되기도 한다. 저자들은 정확한 진단명을 모르는 상태에서 3년 이상 심한 복통으로 고통 받은 장요근의 근막통증증후군 환자를 진료하였기에 이 증례를 문헌고찰과 함께 보고한다.
Abstract
Abdominal pain is one of the most common symptoms we encounter in primary care clinics, and the patients being hospitalized for abdominal pain account for 5-6% of all the inpatients. Careful history taking and physical exams are always necessary for the diagnosis of patients having abdominal pain, because their problems may be transient and insignificant but also can be severe. For the elderly patients, common causes of abdominal pain are unspecific abdominal pain, functional disease, constipation, kidney stone, urinary tract infection, inflammatory bowel disease, biliary tract disease, acute appendicitis, diverticulitis, abdominal aortic aneurysm, peptic ulcer, intestinal obstruction, mesenteric ischemia, malignant tumor, gastroenteritis, etc. and myofacscial pain can also be the cause. We treated an elderly female patient who had suffered severe abdominal pain due to myofascial pain syndrome of the iliopsoas muscle undiagnosed for over 3 years. Therefore we report this case with review of several literatures.
참고문헌 (17)
- Park KH, "Abdominal pain. In: Textbook of family medicine", pp.445~450 (2007), Hankook Medical Publishing Co
- Jung JH, "A study of disease frequency in medical insurance system in Korea", J Korean Acad Fam Med, 16, pp.193~206 (1995)
- Lewis LM, "Etiology and clinical course of abdominal pain in senior patients: a prospective, multicenter study", J Gerontol A Biol Sci Med Sci, 60, pp.1071~1076 (2005)
- Martinez JP, "Abdominal pain in the elderly", Emerg Med Clin North Am, 24, pp.371~388 (2006)
- Laurell H, "Acute abdominal pain among elderly patients", Gerontology, 52, pp.339~344 (2006)
- Buresh CT, "Unusual causes of recurrent abdominal pain", Emerg Med, 38, pp.11~18 (2006)
- Srinivasan R, "Chronic abdominal wall pain: a frequently overlooked problem. Practical approach to diagnosis and management", Am J Gastroenterol, 97, pp.824~830 (2002)
- Clouse RE, "Functional abdominal pain syndrome", Gastroenterology, 130, pp.1492~1497 (2006)
- Simons DG, "Myofascial pain and dysfunction: the trigger point manual. Volume 1. Upper half of body. 2nd ed" (1999), Lippinco Williams & Wilkins
- Han SC, "Myofascial pain syndrome and trigger-point management", Reg Anesth, 22, pp.89~101 (1997)
- Tough EA, "Variability of criteria used to diagnose myofascial trigger point pain syn-drome--evidence from a review of the literature", Clin J Pain, 23, pp.278~286 (2007)
- Travell JG, "Myofascial pain and dysfunction: the trigger point manual. Volume 2. The lower extremities", pp.89~109 (1992), Lippinco Williams & Wilkins
- Vos PA, "The psoas minor syndrome", J Int Coll Surg, 44, pp.30~36 (1965)
- Margulies DR, "Psoas muscle hematoma from blunt trauma: an unusual cause of severe abdominal pain", J Trauma, 45, pp.155~156 (1998)
- D'Silva KJ, "Schwannoma of the psoas major muscle presenting with abdominal and back pain", Dig Dis Sci, 48, pp.1619~1621 (2003)
- Ingber RS, "Iliopsoas myofascial dysfunction: a treatable cause of "failed" low back syndrome", Arch Phys Med Rehabil, 70, pp.382~386 (1989)
- Spiegel B, "Systematic review: the prevalence of suicidal behaviour in patients with chronic abdo-minal pain and irritable bowel syndrome", Aliment Pharmacol Ther, 26, pp.183~193 (2007)