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Anterior cutaneous nerve entrapment syndrome (ACNES): the forgotten diagnosis

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Abstract

The abdominal wall is an often overlooked source of pain in children with chronic abdominal pain. For example, abdominal wall pain can be caused by the abdominal cutaneous nerve entrapment syndrome (ACNES). ACNES occurs in children as well as adults. In pediatrics, this diagnosis is largely unknown. ACNES is characterized by a sharp stabbing pain which characteristically increases with the use of abdominal muscles (Carnett’s sign). The pain is usually located in the lower right quadrant. Very often patient go through a long clinical track, sometimes leading to frequent hospitalizations and unnecessary examinations. In some cases, children even end up in the psychiatric circuit because of misunderstood pain symptoms. We describe three illustrative cases of abdominal pain in which eventually ACNES was diagnosed and successfully treated with infiltration of an anesthetic agent, and we also performed a literature search. Conclusion: ACNES is a relatively unknown cause of abdominal pain in children. Diagnosis and treatment of ACNES are simply by local injection of anesthetics into the abdominal wall.

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Abbreviations

ACNES:

Abdominal cutaneous nerve entrapment syndrome

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Authors and Affiliations

  1. Department of Pediatrics, Spaarne Hospital, Spaarnepoort 1, P.O. Box 770, 2130 AT, Hoofddorp, The Netherlands

    Samira Akhnikh & Peter de Winter

  2. Department of Surgery, Spaarne Hospital, Hoofddorp, The Netherlands

    Niels de Korte

Authors
  1. Samira Akhnikh
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  2. Niels de Korte
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  3. Peter de Winter
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Correspondence to Samira Akhnikh.

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Akhnikh, S., de Korte, N. & de Winter, P. Anterior cutaneous nerve entrapment syndrome (ACNES): the forgotten diagnosis. Eur J Pediatr 173, 445–449 (2014). https://doi.org/10.1007/s00431-013-2140-2

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  • DOI: https://doi.org/10.1007/s00431-013-2140-2

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