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Intractable Abdominal Pain in a Patient With Spinal Cord Injury: A Case Report

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Patients with spinal cord injury (SCI) may experience several types of chronic pains. Abdominal pain in patients with SCI has gained limited attention and little is yet known about its characteristics and mechanisms. It often has been regarded as visceral pain associated with constipation and distention. Neuropathic pains localized in the abdomen have rarely been reported. We experience a case of intractable abdominal pain in a patient with SCI, neither of visceral pathology nor of musculoskeletal origin. The nature of pain fulfilled the diagnostic criteria for neuropathic pains. The pain was therefore regarded as neuropathic and managed accordingly. The first- and second-line oral drugs available were being performed, unfortunately, adequate pain control was not achieved. We tried an intrathecal lidocaine injection as another treatment option, and the injection had considerable effects.

Abstract

Patients with spinal cord injury (SCI) may experience several types of chronic pains. Abdominal pain in patients with SCI has gained limited attention and little is yet known about its characteristics and mechanisms. It often has been regarded as visceral pain associated with constipation and distention. Neuropathic pains localized in the abdomen have rarely been reported. We experience a case of intractable abdominal pain in a patient with SCI, neither of visceral pathology nor of musculoskeletal origin. The nature of pain fulfilled the diagnostic criteria for neuropathic pains. The pain was therefore regarded as neuropathic and managed accordingly. The first- and second-line oral drugs available were being performed, unfortunately, adequate pain control was not achieved. We tried an intrathecal lidocaine injection as another treatment option, and the injection had considerable effects.

참고문헌 (10)

  1. Calmels P., "Neuropathic pain in spinal cord injury : identification, classification, evaluation", Ann Phys Rehabil Med, 52, pp.83~102 (2009)
  2. Finnerup NB., "Abdominal pain in long-term spinal cord injury", Spinal Cord, 46, pp.198~203 (2008)
  3. Ebert E., "Gastrointestinal involvement in spinal cord injury : a clinical perspective", J Gastrointestin Liver Dis, 21, pp.75~82 (2012)
  4. Siddall PJ., "A proposed algorithm for the management of pain following spinal cord injury", Spinal Cord, 44, pp.67~77 (2006)
  5. Celik EC., "The clinical characteristics of neuropathic pain in patients with spinal cord injury", Spinal Cord, 50, pp.585~589 (2012)
  6. Siddall PJ., "Management of neuropathic pain following spinal cord injury : now and in the future", Spinal Cord, 47, pp.352~359 (2009)
  7. Stone JM., "Chronic gastrointestinal problems in spinal cord injury patients : a prospective analysis", Am J Gastroenterol, 85, pp.1114~1119 (1990)
  8. Neumayer LA., "The acutely affected abdomen in paraplegic spinal cord injury patients", Ann Surg, 212, pp.561~566 (1990)
  9. Finnerup NB., "Intravenous lidocaine relieves spinal cord injury pain : a randomized controlled trial", Anesthesiology, 102, pp.1023~1030 (2005)
  10. Siddall PJ., "The efficacy of intrathecal morphine and clonidine in the treatment of pain after spinal cord injury", Anesth Analg, 91, pp.1493~1498 (2000)

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