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Abdominal cutaneous nerve entrapment syndrome

Murid Siawash, Rudi Roumen, Walther Tjon A Ten, Ernst van Heurn, Marc Scheltinga
Some children suffering from chronic abdominal pain may have an abdominal wall entity such as anterior cutaneous nerve entrapment syndrome. This syndrome is largely suspected on a combination of findings at history and physical examination. The aim is to obtain clues in history and physical examinations in a selected population of children with anterior cutaneous nerve entrapment syndrome. We analyzed all children with abdominal pain visiting our hospital between January 2013 and January 2015. A total of 71 cases were identified (median age 15 years, range 8-17, 77% female)...
March 7, 2018: European Journal of Pediatrics
Lindsey B Armstrong, Pradeep Dinakar, David P Mooney
INTRODUCTION: Anterior cutaneous nerve entrapment syndrome (ACNES) is an underrecognized etiology of chronic abdominal pain that causes great morbidity to those affected. We sought to determine the outcome of neurectomy for ACNES in children. METHODS: Demographic and clinical data on children who underwent neurectomy for ACNES by a single surgeon from 10/2011 to 01/2017 were reviewed. RESULTS: Twenty-six patients underwent neurectomy for ACNES...
December 8, 2017: Journal of Pediatric Surgery
M T Tolmos-Estefanía, T Fernández-Rodríguez, Z Bernard-de Casco, C Grande-Díez, Á Rodríguez-Lorenzo
No abstract text is available yet for this article.
December 20, 2017: Semergen
Tomislav Kifer, Zrinjka Mišak, Oleg Jadrešin, Iva Hojsak
OBJECTIVE: Anterior cutaneous nerve entrapment syndrome (ACNES) is often an overlooked cause of abdominal pain. Data for pediatric patients, especially regarding the treatment modalities are scarce. The aim of this study is to present a treatment modality of ACNES with combined local subfascial anesthetic and corticosteroid injection in a prospectively collected cohort of pediatric patients. METHODS: This was a prospective observational long-term study, which included pediatric patients who were diagnosed with ACNES in a tertiary care pediatric center and followed up for at least 12 months (median 1...
November 17, 2017: Clinical Journal of Pain
Jonathan Margalith, Reza Kehtari
Abdominal wall pain is a poorly recognized clinical problem and ofently misdiagnosed. It results in inappropriate diagnostic testing, unsatisfactory treatments and considerable costs. However, chronic abdominal wall pain can be easily diagnosed by a precise physical examination and can be rapidly and efficiently treated. Awareness of knowing criteria of the diagnosis is important but their validity needs to be evaluated in additional studies.
November 22, 2017: Revue Médicale Suisse
R C Maatman, N E Papen-Botterhuis, M R M Scheltinga, R M H Roumen
BACKGROUND AND AIMS: Chronic abdominal pain may occasionally be due to terminal endings of intercostal nerves (ACNES, abdominal cutaneous nerve entrapment syndrome) that are entrapped in the abdominal wall. Spontaneous neuropathic flank pain may also be caused by involvement of branches of these intercostal nerves. Aim is to describe a series of patients with flank pain due to nerve entrapment and to increase awareness for an unknown condition coined Lateral Cutaneous Nerve Entrapment Syndrome (LACNES)...
October 27, 2017: Scandinavian Journal of Pain
Ryutaro Tanizaki, Yousuke Takemura
BACKGROUND: The identification of anterior cutaneous nerve entrapment syndrome is often challenging, due to no widely accepted standard guidelines regarding laboratory and imaging tests for the diagnosis of ACNES. CASE PRESENTATION: A 77-year-old Japanese man presented with mild lower abdominal pain that had been present for the past 3 years. Physical examination revealed no abdominal pain during palpation, with normal laboratory and imaging testing; therefore, conservative therapy was initiated...
October 11, 2017: BMC Research Notes
Robbert C Maatman, Monique A H Steegers, Oliver B A Boelens, Toine C Lim, Hans J van den Berg, Sandra A S van den Heuvel, Marc R M Scheltinga, Rudi M H Roumen
BACKGROUND: Some patients with chronic abdominal pain suffer from an anterior cutaneous nerve entrapment syndrome (ACNES). This somewhat illusive syndrome is thought to be caused by the entrapment of end branches of the intercostal nerves residing in the abdominal wall. If ACNES is suspected, a local injection of an anesthetic agent may offer relief. If pain is recurrent following multiple-injection therapy, an anterior neurectomy entailing removal of the entrapped nerve endings may be considered...
August 2, 2017: Trials
Rudi M H Roumen, Wouter Vening, Rosanne Wouda, Marc M Scheltinga
BACKGROUND: Anterior cutaneous nerve entrapment syndrome (ACNES) is a neuropathic abdominal wall pain syndrome typically characterized by locally altered skin sensations. On the other hand, visceral disease may also be associated with similar painful and altered skin sensations ("Head zones"). Aim of the study was to determine if patients with acute appendicitis demonstrated somatosensory disturbances in the corresponding right lower quadrant Head zone. METHODS: The presence of somatosensory disturbances such as hyperalgesia, hypoesthesia, altered cool perception, or positive pinch test was determined in 100 patients before and after an appendectomy...
June 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Oliver B Boelens, Robert C Maatman, Marc R Scheltinga, Kees van Laarhoven, Rudi M Roumen
Most patients with chronic back pain suffer from degenerative thoracolumbovertebral disease. However, the following case illustrates that a localized peripheral nerve entrapment must be considered in the differential diagnosis of chronic back pain. We report the case of a 26-year-old woman with continuous excruciating pain in the lower back area. Previous treatment for nephroptosis was to no avail. On physical examination the pain was present in a 2 x 2 cm area overlying the twelfth rib some 4 cm lateral to the spinal process...
March 2017: Pain Physician
Murid Siawash, Frederique Mol, Walther Tjon-A-Ten, Christel Perquin, Percy van Eerten, Ernst van Heurn, Rudi Roumen, Marc Scheltinga
BACKGROUND: Chronic abdominal pain in children may be caused by the anterior cutaneous nerve entrapment syndrome. Local nerve blocks are recommended as an initial treatment in adults. Evidence on effectiveness and safety of such a treatment in children is lacking. AIM: Our aim was to study outcome and adverse events of anterior rectus sheath blocks in childhood anterior cutaneous nerve entrapment syndrome. METHODS: Patients <18 years of age receiving anterior rectus sheath blocks were prospectively followed...
May 2017: Paediatric Anaesthesia
Murid Siawash, Robbert Maatman, Walther Tjon A Ten, Ernst van Heurn, Rudi Roumen, Marc Scheltinga
INTRODUCTION: Anterior cutaneous nerve entrapment syndrome (ACNES) is a relatively unknown cause of severe neuralgic abdominal pain. Treatment includes medication, local nerve blocks or, if unresponsive, a neurectomy of nerve endings. In children, the outcome of neurectomy for ACNES is scantly described in retrospective studies. The objective of this first prospective study was to investigate the safety and short term success rate of anterior neurectomy in a large pediatric population with ACNES...
March 2017: Journal of Pediatric Surgery
Jeremy R Glissen Brown, Gregory R Bernstein, Frank K Friedenberg, Adam C Ehrlich
Chronic abdominal wall pain (CAWP) refers to a condition wherein pain originates from the abdominal wall itself rather than the underlying viscera. According to various estimates, 10% to 30% of patients with chronic abdominal pain are eventually diagnosed with CAWP, usually after expensive testing has failed to uncover another etiology. The most common cause of CAWP is anterior cutaneous nerve entrapment syndrome. The diagnosis of CAWP is made using an oft-forgotten physical examination finding known as Carnett's sign, where focal abdominal tenderness is either the same or worsened during contraction of the abdominal musculature...
November 2016: Journal of Clinical Gastroenterology
Sule Sahin Onat, Ayse Merve Ata, Levent Ozcakar
Meralgia paresthetica refers to the entrapment of the lateral femoral cutaneous nerve at the level of the inguinal ligament. The lateral femoral cutaneous nerve - a purely sensory nerve - arises from the L2 and L3 spinal nerve roots, travels downward lateral to the psoas muscle, and then crosses the iliacus muscle. Close to the anterior superior iliac spine, the nerve courses in contact with the lateral aspect of the inguinal ligament and eventually innervates the lateral thigh. The entrapment syndrome is usually idiopathic but can also ensue due to trauma/overuse, pelvic and retroperitoneal tumors, stretching of the nerve due to prolonged leg/trunk hyperextension, leg length discrepancies, prolonged standing, external compression by belts, weight gain, and tight clothing...
May 2016: Pain Physician
Jelmer E Oor, Çagdas Ünlü, Eric J Hazebroek
BACKGROUND: Abdominal cutaneous nerve entrapment syndrome (ACNES) is a frequently overlooked cause of chronic abdominal pain. We aim to outline the current available literature concerning the treatment of patients diagnosed with ACNES. DATA SOURCES: A systematic search in PubMed, EMBASE, CINAHL, and Cochrane databases was performed. Seven studies were included; describing trigger point injection (TPI) or anterior neurectomy as stand-alone procedure, TPI followed by anterior neurectomy as stepwise regimen, and nerve stimulation and phenolization...
July 2016: American Journal of Surgery
Herbert Koop, Simona Koprdova, Christine Schürmann
BACKGROUND: Chronic abdominal wall pain is a poorly recognized clinical problem despite being an important element in the differential diagnosis of abdominal pain. METHODS: This review is based on pertinent articles that were retrieved by a selective search in PubMed and EMBASE employing the terms "abdominal wall pain" and "cutaneous nerve entrapment syndrome," as well as on the authors' clinical experience. RESULTS: In 2% to 3% of patients with chronic abdominal pain, the pain arises from the abdominal wall; in patients with previously diagnosed chronic abdominal pain who have no demonstrable pathological abnormality, this likelihood can rise as high as 30% ...
January 29, 2016: Deutsches Ärzteblatt International
Sven Weum, Louis de Weerd
BACKGROUND: Pain from the abdominal wall can be caused by nerve entrapment, a condition called abdominal cutaneous nerve entrapment syndrome (ACNES). As an alternative to surgery, ACNES may be treated with injection of local anesthetics, corticosteroids, or botulinum toxin at the point of maximal pain. METHOD: The point of maximal pain was marked on the abdominal skin. Using color Doppler ultrasound, the corresponding exit point of perforating blood vessels through the anterior fascia of the rectus abdominis muscle was identified...
July 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Rajendra Kumar Sahoo, Abhijit S Nair
Anterior cutaneous nerve entrapment syndrome (ACNES) is one the most common cause of chronic abdominal wall pain. The syndrome is mostly misdiagnosed, treated wrongly and inadequately. If diagnosed correctly by history, examination and a positive carnett test, the suffering of the patient can be relieved by addressing the cause i.e. local anaesthetic with steroid injection at the entrapment site. Conventionally, the injection is done by landmark technique. In this report, we have described 2 patients who were diagnosed with ACNES who were offered ultrasound guided transverses abdominis plane (TAP) injection who got significant pain relief for a long duration of time...
October 2015: Korean Journal of Pain
Vincent M A Stirler, Johan T F J Raymakers, Srdjan Rakic
BACKGROUND: The aim of the study was to introduce a new surgical treatment for anterior cutaneous nerve entrapment syndrome, a frequently unrecognised disorder in the general population responsible for chronic abdominal wall pain with limited treatment options to date. We hypothesised that intraperitoneal onlay mesh reinforcement could dissipate excessive increases in intra-abdominal pressure and prevent entrapment of the neurovascular bundle. METHODS: Retrospective cohort analysis was performed between September 2002 and March 2014...
July 2016: Surgical Endoscopy
Murid Siawash, Jenneke W A de Jager-Kievit, Walther Tjon A Ten, Rudi M Roumen, Marc R Scheltinga
OBJECTIVE: Anterior cutaneous nerve entrapment syndrome (ACNES) is a frequently overlooked condition causing chronic abdominal pain (CAP). The objective of the present study was to investigate the rate of ACNES in a pediatric outpatient cohort with CAP. METHODS: A cross-sectional cohort study was conducted in a population 10 to 18 years of age consulting a pediatric outpatient department with new-onset CAP during a 2 years' time period. All individuals were identified through a standard hospital registration system...
March 2016: Journal of Pediatric Gastroenterology and Nutrition
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