Abstract
Summary Pain produced by balloon distention of the intestinal tract and by water distention of the biliary passages was studied in normal human subjects and in patients following unilateral or bilateral lumbodorsal sympathectomy. Following unilateral sympathectomy, 1) pain is referred to the contralateral side; 2) the degree of the contralateral reference varies with the intestinal area stimulated; and 3) the threshold of pain is elevated. Following bilateral sympathectomy, distention pain is abolished. Limited evidence suggests that pain pathways from the jejunum may pass through the 10th, 11th, and 12th thoracic sympathetic ganglia and not invariably through the greater splanchnic nerves. Case reports of sympathectomized patients with various abdominal disorders are presented to illustrate that abdominal pain in these patients may be abolished, or grossly altered, or unchanged following sympathetic denervation. Since the results obtained by balloon distention suggest that true visceral pain is abolished following sympathectomy, it appears that other mechanisms and pathways account for such pain as the sympathectomized patient with abdominal disorders may experience.
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