Five days later
discography was done by the postero-lateral approach at the third, fourth and fifth lumbar levels.
Difficulty was encountered in gaining entrance to the fifth lumbar disc space and multiple dural
punctures were probably made before the needle was properly placed. The discographs were read
as showing degeneration at the third and fifth lumbar levels and extrusion at the fourth level with
epidural leak of the contrast medium. Chymopapain, 10 milligrams, was injected into each disc.
The patient’s sciatic pain disappeared six hours after injection, but he complained of severe back and
abdominal pain. For the ensuing five days he showed signs of an unlocalised acute abdominal crisis
of such severity as to raise the question of exploratory laparotomy. Seven days after the injection,
the patient’s abdominal distress was subsiding and he had no complaint of back or extremity pain,
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