Abdominal pain as a misleading symptom of spinal cord lesions

Summary

Clinical reports of several cases of spinal cord lesions have been presented in order to point out that such lesions, through irritation of posterior nerve roots, may produce abdominal pain which is easily confused with that caused by visceral disease. Particular attention is called to the condition known as chronic spinal arachnoiditis as a causative factor and to the fact that its presence may and frequently does lead to fruitless abdominal surgery.

Certain features of abdominal pain caused by spinal lesions should serve to arouse suspicion as to its true nature. These features are persistance in a definite location over a long period of time, aggravation by changes in body position, increase in pain by sneezing or coughing and association with pain in the lower back or lower extremities or with girdle sensation about the trunk.

Mistakes in diagnosis can be avoided by proper appreciation of these characteristics and by examining the patient for motor, reflex and sensory disturbances which, although usually not marked, are frequently present.