Diabetic neuropathy, the great masquerader: truncal neuropathy manifesting as abdominal pseudohernia.

Objective: To describe a patient with diabetic truncal neuropathy and suggest a helpful diagnostic approach to this entity. Methods: We present a case report, with a focus on physical, computed tomographic, and electromyographic findings. Results: Because of an extensive differential diagnosis, diabetic truncal neuropathy is a rarely recognized and often misdiagnosed condition in patients with diabetes mellitus. In a 55-year-old man with a 13-year history of diabetes but no retinopathy, vasculopathy, or nephropathy, pain and a visible bulge in the left lower abdominal quadrant prompted radiographic assessment of the abdomen. A computed tomographic scan of the abdomen disclosed no mass but a weakening of the abdominal musculature suggestive of a pseudohernia. Subsequent electromyography showed evidence of polyradicular neuropathy. The patient was given treatment for pain control, and the pseudohernia resolved within 1 year. Conclusion: In patients with diabetes who have a painful abdominal mass, the potent...