Pediatrics & Therapeutics
Open Access

Anterior Cutaneous Nerve Entrapment Syndrome (ACNES): The forgotten diagnosis

4^th International Conference on Pediatrics & Pediatric Emergency Medicine

March 29-31, 2016 Atlanta, Georgia, USA

J Peter de Winter

Spaarne Gasthuis Hoofddorp, the Netherlands

Posters & Accepted Abstracts: Pediat Therapeut

Abstract :

Anterior cutaneous nerve entrapment syndrome (ACNES) is an often overlooked cause of (chronic) abdominal pain. This was first recognized by Carnett and Bates in his seminal article in 1926. However, nowadays, many physicians are still unaware of this diagnosis. The literature on prevalence of ACNES in the pediatric population is very scarce. Only recently, ACNES has been described in children. Abdominal pain can be classified as visceral pain caused by intra-abdominal organs or parietal pain originating in the abdominal wall. ACNES causes��? abdominal wall pain and it is believed that in ACNES, superficial branches of the intercostal thoracic nerves become entrapped between the abdominal muscles and cause pain on this specific location of entrapment. In its presentation, ACNES may therefore mimic an intra-abdominal source of the pain like appendicitis. Carnett first described a test in which the specific point of maximal pain is identified by the investigator after placing patient in supine position. The patient is then asked to raise the head and shoulders. When doing the test right, the abdominal muscles should be contracted. The pain will increase and is pinpointed with a fingertip. Carnett��?s sign is then positive and ACNES becomes more probable. Pain of visceral origin usually diminishes during this test. Immediate relief of pain after administering a local dose of anaesthetic in the rectus sheath at the location of the point of maximal tenderness strongly supports the diagnosis of ACNES which is also first line in treatment for ACNES

Biography :

Email: PdeWinter@spaarneziekenhuis.nl