| Anorectal fissures: an under-recognized cause of low back pain? Case report. | |
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MedLine Citation:
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PMID: 20217995 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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INTRODUCTION: Low back pain is one of the most common complaints for which patients seek medical attention. The differential for such a complaint is wide and therefore requires a thoughtful and thorough work-up. Anorectal disorders are an often-overlooked cause of low back pain. CASE PRESENTATION: We discuss the case of a 46-year-old male with history of dull aching back pain in the midline at the lumbosacral junction. The pain extended to the left of midline, into the region of the sacroiliac joint. There was no radiation into the buttock or leg. Physical exam was unremarkable. Upon soliciting further history, the patient reported a long history of anal pruritus and occasional hematochezia. Colonoscopy subsequently revealed anal fissures in various stages of healing. He was treated with Metamucil capsules and oral nifedipine with significant improvement of his symptoms. CONCLUSION: Low back pain is a challenging chief complaint to the primary care diagnostician due to its wide differential. In a careful and thorough work-up of this complaint, disorders of the anus and rectum should not be overlooked as possible culprits. |
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Authors:
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Kristopher T Kimmell; Jason Lees; Mason B Andrews; Craig H Rabb |
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Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: The Journal of the Oklahoma State Medical Association Volume: 103 ISSN: 0030-1876 ISO Abbreviation: J Okla State Med Assoc Publication Date: 2010 Jan |
Date Detail:
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Created Date: 2010-03-11 Completed Date: 2010-04-08 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7503043 Medline TA: J Okla State Med Assoc Country: United States |
Other Details:
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Languages: eng Pagination: 10-2 Citation Subset: IM |
Affiliation:
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College of Medicine, University of Oklahoma, Oklahoma City, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Administration, Oral Cathartics / administration & dosage, therapeutic use Colonoscopy Diagnosis, Differential Drug Therapy, Combination Fissure in Ano / complications*, diagnosis, drug therapy Follow-Up Studies Humans Low Back Pain / diagnosis, drug therapy, etiology* Male Middle Aged Nifedipine / administration & dosage, therapeutic use Psyllium / administration & dosage, therapeutic use Vasodilator Agents / administration & dosage, therapeutic use |
| Chemical | |
Reg. No./Substance:
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0/Cathartics; 0/Vasodilator Agents; 21829-25-4/Nifedipine; 8063-16-9/Psyllium |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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