Rectus syndrome. Another cause of upper abdominal pain.

Abstract

Rectus syndrome is somatic pain originating from the rectus abdominis musculature of the abdomen. However, pain with its associated somatovisceral symptoms such as nausea, vomiting, and anorexia, is called pseudovisceral pain syndrome. It commonly mimics abdominal visceral pain and misleads medical practitioners into establishing a wrong diagnosis and giving inadequate pain management. Owing to its primary somatic origin, a regional rectus nerve block is an efficacious modality for use in differentiating the diagnosis and providing longlasting optimal pain relief. Two cases, a 48-year-old man and a 41-year-old woman, were referred for the management of chronic upper abdominal pain consistent with chronic pancreatitis. They underwent rectus block, first to differentiate the diagnosis and then to relieve intractable pain problems with multidisciplinary pain management. Rectus block was performed successfully, and a diagnosis of rectus syndrome was established. These two patients responded to the rectus block immediately and received long-lasting pain relief after repeated rectus blocks in conjunction with pharmacologic and psychological treatment and physiotherapy. Rectus syndrome could be another potential cause of chronic intractable upper abdominal pain problem; rectus block provides a simple diagnostic and therapeutic technique to differentiate the diagnosis and treat it adequately.