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Protracted diagnosis of ACNES: a costly exercise
S J Dancer1,2, S G Macpherson3, A C de Beaux4
1Department of Clinical Research, Hairmyres Hospital, NHS, Lanarkshire G75 8RG, UK.
Journal of Surgical Case Reports
|September 13, 2018
Summary
This case report details a 58-year-old female diagnosed with anterior cutaneous nerve entrapment syndrome (ACNES) after a 9-month delay. The study highlights the costly and protracted diagnostic journey for ACNES, emphasizing the need for improved diagnostic pathways.
Area of Science:
- Abdominal Wall Surgery
- Pain Management
- Diagnostic Pathways
Background:
- Anterior Cutaneous Nerve Entrapment Syndrome (ACNES) is a common cause of abdominal wall pain.
- Delayed diagnosis of ACNES can lead to prolonged patient suffering and increased healthcare costs.
Observation:
- A 58-year-old female presented with symptoms later diagnosed as ACNES.
- The patient underwent multiple consultations and investigations over 9 months before diagnosis.
- Diagnosis was confirmed via open exploration of the anterior abdominal wall, followed by nerve release and symptom resolution.
Findings:
- The diagnostic process for this ACNES patient was protracted and costly, amounting to nearly £11,500.
- Initial medical and surgical evaluations missed the diagnosis despite extensive testing.
Implications:
- This case underscores the challenges in diagnosing ACNES, leading to significant healthcare expenditure.
- Optimizing diagnostic strategies for ACNES is crucial for cost-effectiveness in healthcare systems like the NHS.
- Improved awareness and diagnostic tools for ACNES could reduce patient morbidity and healthcare resource utilization.
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