Surgery for Abdominal Wall Pain Caused by Cutaneous Nerve Entrapment in Children-A Single Institution Experience in the Last 5 Years

Žganjer, Mirko; Bojić, Davor; Bumči, Igor

doi:10.5812/ircmj.8422

Cited by 9 publications

(3 citation statements)

References 8 publications

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“…The anterior cutaneous nerve entrapment syndrome (ACNES) can be the origin of chronic abdominal pain (CAP) in children. Interestingly, this often neglected abdominal wall pain syndrome appeared the cause of CAP in 3% of 426 children 1 . At the pediatric department of our hospital, some 13% of 95 children with CAP were diagnosed with ACNES 2 .…”

Section: Introductionmentioning

confidence: 92%

“…Interestingly, this often neglected abdominal wall pain syndrome appeared the cause of CAP in 3% of 426 children. 1 At the pediatric department of our hospital, some 13% of 95 children with CAP were diagnosed with ACNES. 2 However, diagnosing the cause of CAP in children is challenging, as it often depends on multiple physiological and psychological factors.…”

Section: Introductionmentioning

confidence: 96%

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Lidocaine patch as noninvasive alternative treatment option in children with anterior cutaneous nerve entrapment syndrome: A retrospective case series

ten Have,

Zwaans,

Scheltinga

et al. 2024

Pediatric Anesthesia

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BackgroundChronic abdominal pain in children is occasionally caused by anterior cutaneous nerve entrapment syndrome (ACNES). Diagnosing and treating this typical peripheral abdominal wall neuropathy is challenging. Management usually starts with minimally invasive tender point injections. Nevertheless, these injections can be burdensome and might even be refused by children or their parents. However, a surgical neurectomy is far more invasive. Treatment with a Lidocaine 5% medicated patch is successfully used in a variety of peripheral neuropathies.AimsThis single center retrospective case series aimed to evaluate the effectiveness and tolerability of lidocaine patches in children with ACNES.MethodsChildren aged under 18 diagnosed with ACNES who were treated with a 10 day lidocaine patch treatment between December 2021 and December 2022 were studied. Patient record files were used to collect treatment outcomes including pain reduction based on NRS and complications.ResultsTwelve of sixteen children (mean age 13 years; F:M ratio 3:1) diagnosed with ACNES started the lidocaine patch treatment. Two patients achieved a pain free status and remained pain free during a 4 and 7 months follow‐up. A third child reported a lasting pain reduction, but discontinued treatment due to a temporary local skin rash. Five additional patients reported pain reduction only during application of the patch. The remaining four children experienced no pain relief. No adverse effects were reported.ConclusionLidocaine patches provides pain relief in a substantial portion of children with ACNES.

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Section: Introductionmentioning

confidence: 92%

Section: Introductionmentioning

confidence: 96%

Lidocaine patch as noninvasive alternative treatment option in children with anterior cutaneous nerve entrapment syndrome: A retrospective case series

ten Have,

Zwaans,

Scheltinga

et al. 2024

Pediatric Anesthesia

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“…They also have been found to reduce the development of ectopic neural discharge 35,36 . Steroid presumably results in the thinning of connective tissue around the painful nerve 21 . The injection was successful in all cases of the current study.…”

Section: Elriah-pc Medical Journal Ofmentioning

confidence: 99%

Management of chronic abdominal wall pain: A one-year

Habl

Mokhtar

Makharita

et al. 2020

Medical Journal of Viral Hepatitis

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Objectives: This study was designed to determine the prevalence of chronic abdominal wall pain (CAWP) in the gastroenterology clinic unit (GCU) and investigated the criteria of CAWP patients.Therapeutic trials to control such annoying problem were investigated. Methods: The study had two stages; the first stage was a cross-sectional analysis of the adult patients who were suffering from chronic abdominal pain. Patients reporting a score value ≥ 10 on the Questionnaire of CAWP in addition to a positive Carnett´s sign were included in this study. Included patients were subjected to study the criteria of CAWP. The second stage was a randomized clinical trial where anti-neuropathic drugs (e.g. pregabalin-carbamazepine-amitriptyline) were used. Results: CAWP was diagnosed in 30.6% of the screened patients. 76% were female. Upper right quadrant pain was reported in 48.1%. Delay in diagnosis was reported to be 9.14±8.9 months. Misdiagnosis as cholecystitis, peptic ulcer disease and irritable bowel syndrome was reported. 94.4 % of treated patients showed a satisfactory response to anti-neuropathic medications. 5.6 % was successfully controlled by local injection. Significant lower Visual Analogue Scale (VAS) was reported after 2 weeks and 1, 2, 3, 4 and 6 months of the treatment plan implementation when compared to the basal value (p. < 0.001). Conclusions: CAWP was identified in 30.6% of the patients complaining of chronic abdominal pain. Multiple physician consultations, delayed diagnosis, misdiagnosis with subsequent mistreatment were common. While, anti-neuropathic drugs are an effective tool in most cases of CAWP, trigger point injection represents an alternative line of treatment.

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Anterior cutaneous nerve entrapment syndrome (ACNES)

Scheltinga

Roumen

2017

Hernia

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The abdominal wall is frequently overlooked as a potential source of chronic abdominal pain. In anterior cutaneous nerve entrapment syndrome (ACNES), irritated intercostal nerves cause severe abdominal pain. Current textbooks fail to acknowledge ACNES. Aim of the present review is to provide detailed information on patient history, physical examination, and a three-step treatment protocol including abdominal wall injections and a localized removal of terminal branches of intercostal nerves.

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Surgery for Abdominal Wall Pain Caused by Cutaneous Nerve Entrapment in Children-A Single Institution Experience in the Last 5 Years

Cited by 9 publications

References 8 publications

Lidocaine patch as noninvasive alternative treatment option in children with anterior cutaneous nerve entrapment syndrome: A retrospective case series

Lidocaine patch as noninvasive alternative treatment option in children with anterior cutaneous nerve entrapment syndrome: A retrospective case series

Management of chronic abdominal wall pain: A one-year

Anterior cutaneous nerve entrapment syndrome (ACNES)

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