Children with acute pancreatitis may develop chronic abdominal wall pain after resolution of clinical, laboratory, and radiographic signs of disease. We describe a 13-year-old boy who underwent an unrevealing, complex diagnostic evaluation for persistent abdominal pain after resolution of acute pancreatitis. His pain required an extended leave of absence from school and nasogastric tube feeds. After receiving abdominal nerve blocks and trigger point injections, he experienced near-complete resolution of pain with normalization of eating habits and daily function. Pain practitioners should think critically about the signs and symptoms of visceral versus somatic pain and try newer diagnostic interventions that may be therapeutic.
From the Departments of *Anesthesiology and Critical Care Medicine
†Pediatrics, The Johns Hopkins Hospital, Baltimore, Maryland
‡Multidisciplinary Pediatric Pain Clinic, Department of Anesthesiology and Critical Care Medicine, Kennedy Krieger Rehabilitation Institute, Baltimore, Maryland.
Accepted for publication January 8, 2019.
The authors declare no conflicts of interest.
Address correspondence to M-Irfan Suleman, MD, Department of Anesthesiology and Critical Care Medicine, The Charlotte R. Bloomberg Children’s Center, 1800 Orleans St, Suite 6349C, Baltimore, MD 21287. Address e-mail to firstname.lastname@example.org.