title: [Successful endoscopic neural therapy of a patient with chronic pain syndrome after rectum gunshot injury].
abstract: BACKGROUND
  We report about a 39-year-old patient, who was injured by a gunshot which penetrated the abdominal wall and the rectum. As a consequence, he developed a chronic pain syndrome with persistent severe rectal pain during and up to 30 min after defecation. Outpatient treatment for more than 10 years with analgetic agents, glucocorticoids, and salicylates did not show sufficient therapeutic benefit.
  
  
  METHODS
  During flexible rectoscopy, a rectum scar was located and a local injection of procaine into the rectum scar was performed. The patient described a strong and sharp pain during the infiltration which lasted about 5-10 s. Subsequently, the pain resolved. After the intervention as well as at discharge, the patient was completely pain-free.
  
  
  CONCLUSIONS
  This is the first case report describing the successful endoscopic neural therapy of an intraluminal focus causing a chronic pain syndrome refractory to conventional analgetic and anti-inflammatory treatment.
authors.affiliation: Klinik für Naturheilkunde und Integrative Medizin, Kliniken Essen-Mitte, Universität Duisburg-Essen, Deutschland.
authors.forename: Felix J
authors.initials: FJ
authors.lastname: Saha
authors.forename: Volker
authors.initials: V
authors.lastname: Komhard
authors.forename: Jost
authors.initials: J
authors.lastname: Langhorst
mesh_terms: D000328:Adult; D059350:Chronic Pain / Q000188:drug therapy*; D002921:Cicatrix / Q000188:drug therapy*; D016099:Endoscopy, Gastrointestinal; D006801:Humans; D008297:Male; D011343:Procaine / Q000008:administration & dosage*; D012007:Rectum / Q000473:pathology*; D013577:Syndrome
chemical_list: D011343:Procaine