Management of Anterior Cutaneous Nerve Entrapment Syndrome in a Cohort of 139 Patients

Abstract

A regimen of consecutive local trigger point injections is effective in one-thirds of patients with ACNES. Surgical neurectomy is effective in about two-thirds of the injection regimen refractory patients. Eighty percent of the entire ACNES population reports total or substantial pain relief on the long term.

Chronic Abdominal Wall Pain Misdiagnosed as Functional Abdominal Pain

“…A neurectomy will be considered if she remains unresponsive. 14,20 Pain levels of patients 5 and 6 were mild. These 2 individuals were reassured once the origin of the pain was explained.…”

Radiofrequency and Neurolysis for the Treatment of Chronic Visceral Abdominal Pain

“…In terms of treatment, administration of local anesthetic can completely relieve the pain of ACNES [ 34 ]. The needle should be correctly positioned beneath the aponeurotic opening (using ultrasound guidance may improve the targeting of this area).…”

Intraperitoneal onlay mesh reinforcement of the abdominal wall: a new surgical option for treatment of anterior cutaneous nerve entrapment syndrome—a retrospective cohort analysis of 30 consecutive patients

“…Initial treatment of ACNES is conservative and based on local injections with an anaesthetic agent [2]. For patients who fail to respond, surgical neurectomy has been the only viable secondary therapeutic option so far [3,4]. Hereby, we describe a completely new surgical concept as a treatment of intractable ACNES that is based on structural reinforcement of the abdominal wall at the painful area with intraperitoneal onlay mesh (IPOM).…”

“…Meanwhile, another Dutch group pioneered extensive research on ACNES [3,16] and promoted surgical anterior neurectomy as an effective treatment for patients with intractable ACNES [4,17,18]. The reported short-and long-term success rates were 71 and 61 %, respectively [18].…”

“…The diagnosis of ACNES was established as previously described [3,4]. In brief, it was based on a sharply localised pain with a fingertip (trigger point) at the lateral margin of rectus abdominis muscle (can usually be pointed out by the patients themselves), a positive Carnett's sign (increased tenderness during muscle tensing) [5] and exclusion of visceral and hernia pathology (by clinical, chemical and radiological examinations).…”