Abdominal Wall Pain Test

Abdominal wall pain awp is a common and underrecognized cause of chronic abdominal pain. Trigger point injection using either a corticosteroid a local anesthetic or a combination of both often gives relief of pain and is of diagnostic and therapeutic value. The most common cause is an entrapped anterior branch of one of the thoracic nerves but it may also result from surgical scars and hernias.

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History and physical examination are critical to an accurate diagnosis of awp.

Abdominal wall pain test. A positive test indicates the increased likelihood that the abdominal wall and not the abdominal cavity is the source of the pain for example due to rectus sheath hematoma instead of appendicitis. It is characterized by pain localized to a very small area usually at the lateral edge of the rectus abdominis muscle. Chronic abdominal wall pain should be suspected when chronic abdominal pain is narrowly confined to a small area. Pain arising from the abdominal wall has been implicated as a cause of non specific abdominal pain nsap and the presence of abdominal wall tenderness awt has been proposed as an accurate diagnostic test for nsap.

One hundred and fifty eight patients admitted to hospital with abdominal pain were tested for the presence of positive awt. Pain originating from the abdominal wall has been described for nearly 100 years 1 but did not receive much attention until 1926 when a simple bedside test was proposed 2 case reports in the. It has been labeled all of these. 3 4 a negative carnett s sign is said to occur when the abdominal pain decreases when the patient is asked to lift the head.

Abdominal wall pain visceral pain chest wall pain chronic pain syndrome etc. Perform the carnett test to assess for abdominal wall pain which can mimic intra abdominal pathology and often goes undiagnosed. Chronic abdominal wall pain summary. The diagnosis can be established very reliably with the aid of carnett s test.

The abdominal wall as a source of pain has received little attention and only a few reviews on the topic have been published in the past decade 1 2 however physicians who consider abdominal. This points to an intra abdominal cause of the pain. Chronic abdominal wall pain is a common but poorly recognized clinical condition that is often misdiagnosed. Identify the point of maximal pain in the supine patient and palpate there with moderate pressure to elicit tenderness.

The etiology of awp varies. I have received easily 100 injections in my upper abdomen and wrapping around to my back.