A 78-year-old woman was referred from the general surgery service to the pain clinic for chronic abdominal pain secondary to intestinal angina.
No history of chronic degenerative diseases.
Two laparotomies were performed in 6 months and one diagnostic laparoscopy due to episodes of ischemia month.
- Diagnosis: ischemia corroborated by computed tomography with venous and arterial contrast.
- Current illness: a patient with chronic, generalised, severe, 6-month history abdominal pain who does not respond to standard analgesics.
Cramping pain, VAS 10/10, severe, disabling, episodic EVERA, which is sometimes accompanied by nausea and vomiting, without factors that increase or decrease it.
Physical restraint: weight 45 kg; height 1.50 m; blood pressure 90/50 mmHg; heart rate 65; respiratory rate 18.
Awareness, oriented, hydrated, mucous membrane tenderness and tegument, cachectic.
The face, head and neck were unaltered, cardiopulmonary without involvement, abdomen with generalized pain in all quadrants, severe, superficial and deep, peristalsis present and normal characteristics, without palpable masses.
Physical examination was normal.
- algological diagnosis: severe chronic visceral abdominal pain.
- Etiological diagnosis: intestinal angina (ischemia month).
1.
Ev
Therapy with potent opioids (hydromorphinone, methadone, oxycodone, morphine and transdermal fentanyl) and adjuvants, such as calcium antagonists, nitrates, etc., with different rotations and clinical course
Non-interventional treatment due to acenocoumarin anticoagulation and antiplatelet agents.
