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Edorium Journal of

Surgery

 
     
Original Article
 
Truncal neuralgia in diabetic patients: An ignored cause of abdominal pain
Mohamed Lotfy1, Hazem N. Ashri1, Mostafa M. Khairy1
1MD, Department of Surgery, Faculty of Medicine, Zagazig University, Egypt

Article ID: 100019S05ML2017
doi:10.5348/S05-2017-19-OA-3

Address correspondence to:
Mohamed Lotfy
Department of Surgery, Faculty of Medicine
Zagazig University
Egypt

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How to cite this article
Lotfy M, Ashri HN, Khairy MM. Truncal neuralgia in diabetic patients: An ignored cause of abdominal pain. Edorium J Surg 2017;4:14–17.


ABSTRACT

Aims: We aim to study diabetic patients, with abdominal pain and neuralgia somewhere else in their bodies, and search for the relation between their abdominal pain and the lower intercostal neuralgia (T7–11 and subcostal).
Methods: Between July 2016 and February 2017 this study was carried out in the emergency department, Zagazig University Hospital. Twenty-three patients were subjected to this study and divided into (group A = 15 patients had right upper abdominal pain) and (group B = 8 patients had right lower abdominal pain). This grouping was not created for comparative reasons, it was done because we were studying the abdominal pain in two different anatomical regions.
Results: In group A, Carnett’s sign was positive in 13 patients and equivocal in two patients (these two patients were operated for cholecystectomy). After strict blood glucose control and starting the neuropathy treatment 13 patients’ symptoms improved. The other two patients developed pyrexia, leukocytosis and high liver enzymes and the diagnosis of acalculous cholecystitis was established. Patients stayed in the hospital for four days (mean) (range 3–6 days). In group B, Carnett’s sign was positive in seven patients and equivocal in one patient (operated for appendectomy). After strict blood glucose control and starting the neuropathy treatment seven patients’ symptoms improved and pain diminished within the 1st 48 hours of admission. Patients stayed in the hospital for three days (mean) (range 2–4 days).
Conclusion: Truncal neuralgia is a probable cause of abdominal pain especially in diabetics suffering from polyneuropathy somewhere else in their bodies. Truncal neuralgia should be put in the surgeon’s mind when managing any diabetic patient with abdominal pain of unrevealed aetiology by the usually used investigations.


Keywords: Abdominal pain, Diabetic, Truncal neuralgia

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Author Contributions
Mohamed Lotfy – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Hazem N. Ashry – Substantial contributions to conception and design, Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Mostafa M. Khairy – Substantial contributions to conception and design, Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© 2017 Mohamed Lotfy et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.





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