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.