RECTUS SYNDROME - ANOTHER CAUSE OF UPPER ABDOMINAL-PAIN

Background and Objectives. Rectus syndrome is somatic pain originating from the rectus abdominis musculature of the abdomen. However, pain w ith its associated somatovisceral symptoms such as nausea, vomiting, a nd anorexia, is called pseudovisceral pain syndrome. It commonly mimic s abdominal visceral pain and misleads medical practitioners into esta blishing a wrong diagnosis and giving inadequate pain management. Owin g to its primary somatic origin, a regional rectus nerve block is an e fficacious modality for use in differentiating the diagnosis and provi ding longlasting optimal pain relief. Methods. Two cases, a 48-year-ol d man and a 41-year-old woman, were referred for the management of chr onic upper abdominal pain consistent with chronic pancreatitis. They u nderwent rectus block, first to differentiate the diagnosis and then t o relieve intractable pain problems with multidisciplinary pain manage ment. Results. Rectus block was performed successfully, and a diagnosi s of rectus syndrome was established. These two patients responded to the rectus block immediately and received long-lasting pain relief aft er repeated rectus blocks in conjunction with pharmacologic and psycho logical treatment and physiotherapy. Conclusion. Rectus syndrome could be another potential cause of chronic intractable upper abdominal pai n problem; rectus block provides a simple diagnostic and therapeutic t echnique to differentiate the diagnosis and treat it adequately.