MedElevator
Войти в исследования Medicine · 2026
Third lumbar transverse process syndrome with acute abdominal pain as the main clinical manifestation: A case report.
СтатьяКлинический случайНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Wei Guangcheng, Yan Ningjuan, Zhao Guodong, Liu Tao, Chen Ming, Qin Weikai, Zhao Yong
Аннотация
RATIONALE: Third lumbar transverse process syndrome is an uncommon musculoskeletal cause of referred abdominal pain. Because acute abdominal pain is appropriately evaluated first for visceral, vascular, urinary, and surgical emergencies, a spinal or paraspinal pain generator may be overlooked.
PATIENT CONCERNS: A 66-year-old man presented with persistent left lower-quadrant abdominal pain radiating to the left lower back. Baseline pain intensity was 7/10 on a VAS, and the pain was aggravated by postural change, standing, and walking.
DIAGNOSES: Serial laboratory tests, endoscopy, ultrasonography, CT/CTA, and specialist consultations did not identify a visceral, urinary, surgical, or hemodynamically significant vascular disorder sufficient to explain the pain. Targeted musculoskeletal examination showed focal tenderness and increased soft-tissue tension around the left L3 transverse process, movement-related pain, and a visually estimated compensatory apparent leg-length discrepancy. These findings supported a clinical diagnosis of third lumbar transverse process syndrome presenting as referred abdominal pain.
INTERVENTIONS: The patient received Tuina manual therapy, two acupotomy closed-release procedures at palpation-defined tender points in the left lumbar and gluteal regions, and adjunctive pharmacotherapy.
OUTCOMES: At discharge on February 9, 2021, the abdomen was soft without tenderness or rebound tenderness. Abdominal pain had resolved completely at the 2-week follow-up. Routine annual telephone follow-up of former inpatients was then conducted once yearly for 3 years, with no recurrence reported.
LESSONS: After urgent abdominal and vascular disorders have been excluded, history taking and targeted examination of the lumbar transverse processes may identify a musculoskeletal source of otherwise unexplained abdominal pain.
PATIENT CONCERNS: A 66-year-old man presented with persistent left lower-quadrant abdominal pain radiating to the left lower back. Baseline pain intensity was 7/10 on a VAS, and the pain was aggravated by postural change, standing, and walking.
DIAGNOSES: Serial laboratory tests, endoscopy, ultrasonography, CT/CTA, and specialist consultations did not identify a visceral, urinary, surgical, or hemodynamically significant vascular disorder sufficient to explain the pain. Targeted musculoskeletal examination showed focal tenderness and increased soft-tissue tension around the left L3 transverse process, movement-related pain, and a visually estimated compensatory apparent leg-length discrepancy. These findings supported a clinical diagnosis of third lumbar transverse process syndrome presenting as referred abdominal pain.
INTERVENTIONS: The patient received Tuina manual therapy, two acupotomy closed-release procedures at palpation-defined tender points in the left lumbar and gluteal regions, and adjunctive pharmacotherapy.
OUTCOMES: At discharge on February 9, 2021, the abdomen was soft without tenderness or rebound tenderness. Abdominal pain had resolved completely at the 2-week follow-up. Routine annual telephone follow-up of former inpatients was then conducted once yearly for 3 years, with no recurrence reported.
LESSONS: After urgent abdominal and vascular disorders have been excluded, history taking and targeted examination of the lumbar transverse processes may identify a musculoskeletal source of otherwise unexplained abdominal pain.