[ANTERIOR CUTANEOUS NERVE ENTRAPMENT SYNDROME IN THE ABDOMINAL WALL]

Area of Science:

• Gastroenterology
• Pain Medicine
• Neurology

Background:

• Anterior cutaneous nerve entrapment syndrome (ACNES) is a frequent cause of chronic abdominal pain.
• Characterized by intense, localized pain exacerbated by movement, ACNES often presents without clear pathological findings on standard diagnostic tests.
• Clinical suspicion and physical examination are crucial for initial diagnosis.

Purpose of the Study:

• To highlight the diagnostic challenges and effective management strategies for ACNES.
• To emphasize the importance of physical examination in diagnosing ACNES.
• To review current treatment options for patients suffering from chronic abdominal pain due to ACNES.

Main Methods:

• Diagnosis confirmed by significant pain relief after local anesthetic injection at the point of maximal tenderness.
• Review of clinical presentation, diagnostic criteria, and treatment outcomes for ACNES.
• Physical examination techniques to identify the characteristic localized tenderness of ACNES.

Main Results:

• ACNES diagnosis is confirmed by a positive response to local anesthetic blockade.
• Effective treatments include local anesthetic injections, corticosteroids, radiofrequency neurotomy, and surgery.
• Accurate diagnosis and timely treatment lead to pain relief in the majority of ACNES patients.

Conclusions:

• ACNES is an underdiagnosed cause of chronic abdominal pain that requires a high index of clinical suspicion.
• Diagnostic confirmation through anesthetic injection is a reliable method.
• A multimodal treatment approach, including interventional procedures, can effectively manage ACNES pain.