Abdominal problems in patients with spinal cord lesions.

The physiatrist faces two major difficulties when dealing with abdominal problems in spinal cord-injured patients: (1) realizing when there is a serious problem; and (2) determining the etiology of the problem. Patients are presented which demonstrate these difficulties. One patient with a ruptured appendix and the periappendicial abscess had only mild symptoms whereas another patient with severe abdominal pain, rigidity and rebound tenderness had a viral enteritis. The neurologic innervations of the abdomen and the various signs and symptoms appearing in cord-injured patients with abdominal problems are described. A methodical evaluation procedure for acute problems in paraplegic patients is presented.