Shallow chest and abdominal wall in the cord with pain or referred pain

Introduction Most patients with thrombophlebitis of the abdominal wall see a doctor because of the discovery that the chest and abdomen wall is shallow and the cord is accompanied by spontaneous pain or activity. Abdominal thrombophlebitis is a venous inflammation of the superficial vein of the abdominal wall due to thrombosis. Mondor first reported the disease in 1939, so it is also known as Mondor disease. Mondor has made a careful observation and study of pathology, confirming that the disease is occlusive endometritis.

Cause

(1) Causes of the disease

The cause is unknown. There is often a history of trauma before the onset of the disease, which is thought to be related to breast surgery, abscessation and local compression; or due to infectious allergic reactions such as tuberculosis, colds and hepatitis.

(two) pathogenesis

In the pathological specimens of early cases, the degeneration reactivity of the vessel wall was observed. There was lymphoid material in the lumen of the cord, no red blood cell components, and lack of muscle fibers and elastic fibers, so it was considered to be caused by mild inflammation of lymphatic vessels. . Domestic Zhang et al. found through pathological observation that there are degenerative red blood cells and fresh blood clots in the lumen of acute cases, so it is considered that this disease is a venous intima lesion caused by venous thrombosis. The course of disease varies from 15 days to 15 months.

an examination

Related inspection

Blood routine abdominal vascular ultrasound examination chest B-ultrasound

Most patients see a doctor because they find that the chest and abdomen wall is shallow and the cord is accompanied by spontaneous pain or activity. The short course of the disease has spontaneous pain.

The chest and abdomen wall is shallow in the examination of the cord with pain or pain:

1. Shallow in the line: In the early stage of the onset, there is one shallow and small cable in the chest and abdomen wall, which is gradually extended. The upper abdominal wall can be extended to the chest wall to the armpit; the lower abdominal wall is toward the groin.

2. Pain: At the same time as the discovery of the cord, the patient often suffers from spontaneous pain or pain during the activity, which becomes the cause of the patient's visit. Elderly patients with long-term illness can also have no symptoms.

3. Physical examination: The chest and abdomen wall can be seen under the skin, the skin is light and hard, and there is no redness and swelling. When one end of the cable is tightened with a finger, a concave shallow groove can appear on the skin, such as tightening the ends. A strip-like bulge may appear on the skin, with localized tenderness of varying degrees.

Differential diagnosis

The differential diagnosis of the chest and abdomen wall with pain or pain in the cord:

1, thoracic pain: thoracic pain is the main clinical manifestations of thoracic spondylosis, common thoracic vertebrae hyperplasia, spinal stenosis; thoracic vertebral compression fracture, dislocation, scoliosis, fascia incarceration; and thoracic disc herniation.

2, chest wall pain: chest wall pain (chestwallpain) also known as musculoskeletal pain (musculoskeletalpain).

3, persistent chest pain or blurred back pain: patients with thoracic ligament ossification of the posterior longitudinal ligament, persistent back pain, its history can last from several months to several years. All 12 patients treated with anterior surgery reported by Kenji Hannai complained of persistent chest pain or blurred back pain. The posterior longitudinal ligament ossification of the thoracic spine (OPLL) is not a common disease worldwide, but it is not uncommon in some countries in the Far East to ossify the posterior longitudinal ligament, resulting in paralysis of the limbs and hospital visits.

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