Dor visceral em pós-operatório complicado de cirurgia urológica: relato de caso

Abstract

BACKGROUND AND OBJECTIVES: Patients may have visceral pain in different parts of the body. This pain is perceived as diffuse, differently from painful skin stimulation pain, with regard to location and interval of presentation. This study aimed at showing a case of visceral pain in a patient submitted to urological procedure followed by postoperative complication. CASE REPORT: Male patient, 60 years old, using warfarin, entered the first-aid unit with abdominal pain predominantly in the left flank, 48 hours after transuretral urological procedure. Investigation has identified the presence of retroperitoneal hematoma in left renal fascia. Initially patient was conservatively treated with intravenous morphine by patient-controlled analgesia pump. Since hematoma has increased, we decided for left nephrectomy surgical procedure. CONCLUSION: The neurophysiologic convergence of somatic and visceral afferents entering the central nervous system seems to explain referred visceral pain, where noxious viscera stimuli induce referred pain in somatic areas. This report illustrates a case of acute visceral pain management where venous patientcontrolled analgesia with morphine associated to dipirone was used to control pain, for which it was effective.