How many cases of chronic abdominal pain and symptoms could be due to a thoracic disc hernia?
"Francisco Javier Pérez Lara,J. Quintero Quesada,J. A. Moreno Ramiro,R. Bustamante Toledo, A. Del Rey Moreno, H. Oliva Muñoz. Chronic Abdominal Syndrome Due to Nervous Compression. Study of 100 Cases and Proposed Diagnostic-Therapeutic Algorithm. Journal of Gastrointestinal Surgery
March 2015,Open Access"
In some cases a chronic groin pain , usually referred to a groin hernia or a postherniorraphy sequela, can depend actually on T12-L2 disc hernia.....
According to our observations the proportion of patients with chronic abdominal pain caused by spine pathology may reach 10-15%. More often pain occurs in subcostal areas, less frequently in the hypogastric region, least often in epigastric region. In these cases careful questioning can ascertain dependence pain from changes of body position, posture or physical load, though most patients do not accented on this. At the initial examination about 90% of these patients during paravertebral palpation can to reveal pain in appropriate segmentary zones, in a one third of them with increased abdominal pain. In most cases effectual is using centrally acting muscle relaxant and nonsteroidal anti-inflammatory drugs.
In the investigation and evaluation of abdominal pains it should be obligatory to eliminate "parietal" wall sources of the pain, e.g. Herpes Zoster, Rib fractures, intercostal neuralgias, hernias, etc. Thoracic nerve dermatomes or segmental pain levels to the epigatrium is 4rth, to umbilical level is the 10th, and the groin is the 12th thoraqcic nerves ( Ileo inguinal and Iliohypogastricnerves) and in between segments.. Significant however is that they do not cross the midline of the abdomen and signs of peritoneal irritation is absent. You will only need to refine your interrogation and perform your PE. I hope this helps.
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