title: [Pain originating from the abdominal wall: a forgotten diagnostic option].
abstract: Chronic abdominal pain is a common clinical problem in primary care, and is usually referred to gastroenterologists or general surgeons. Although up to 20% of cases of idiopathic abdominal pain arise in structures of the abdominal wall, this is frequently overlooked as a possible cause. It includes pain arising from structures of the abdominal wall including skin, parietal peritoneum, cellular subcutaneous tissue, aponeuroses, abdominal muscles and somatosensorial innervation from lower dorsal roots. The diagnosis is based on anamnesis and physical examination. Carnett's sign is a simple maneuver that discriminates between parietal and visceral pain. Management with topical anesthesia is effective in a majority of patients and can help to confirm the diagnosis.
authors.affiliation: Servicio de Gastroenterología, Hospital Ramón y Cajal, Madrid, España. rivernautaes@yahoo.es
authors.forename: Miguel
authors.initials: M
authors.lastname: Rivero Fernández
authors.forename: Víctor
authors.initials: V
authors.lastname: Moreira Vicente
authors.forename: José María
authors.initials: JM
authors.lastname: Riesco López
authors.forename: Miguel Angel
authors.initials: MA
authors.lastname: Rodríguez Gandía
authors.forename: Elena
authors.initials: E
authors.lastname: Garrido Gómez
authors.forename: José María
authors.initials: JM
authors.lastname: Milicua Salamero
mesh_terms: D015746:Abdominal Pain / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D034861:Abdominal Wall / Q000294:innervation / Q000503:physiopathology*; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000627:therapeutic use; D002908:Chronic Disease; D006406:Hematoma / Q000175:diagnosis / Q000503:physiopathology; D046449:Hernia, Abdominal / Q000175:diagnosis; D006801:Humans; D007267:Injections; D009119:Muscle Contraction; D009209:Myofascial Pain Syndromes / Q000175:diagnosis; D009408:Nerve Compression Syndromes / Q000175:diagnosis / Q000503:physiopathology; D009413:Nerve Fibers, Myelinated / Q000502:physiology; D036421:Nerve Fibers, Unmyelinated / Q000502:physiology; D009619:Nociceptors / Q000502:physiology; D019800:Phenol / Q000008:administration & dosage / Q000627:therapeutic use; D010808:Physical Examination; D012867:Skin / Q000294:innervation
chemical_list: D000779:Anesthetics, Local; D019800:Phenol