Download PDF
CC BY-NC-ND 4.0 · Endosc Int Open 2022; 10(04): E544-E548
DOI: 10.1055/a-1784-0504
Original article

Endoscopy-induced anterior cutaneous nerve entrapment syndrome: a case series

Frank H.J. Wolfhagen
Department of Gastroenterology and Hepatology, Albert Schweitzer Hospital, Dordrecht, The Netherlands
› Author Affiliations
› Further Information
Also available at
   Permissions and Reprints

Abstract

Background and study aims Anterior cutaneous nerve entrapment syndrome (ACNES) is a common but frequently overlooked disorder. Here we report on a series of patients with ACNES following endoscopy.

Patients and methods This case series included consecutive patients with localized abdominal pain following an endoscopic procedure that was consistent with ACNES who presented to the author’s Gastroenterology Outpatient Clinic from February 2019 to February 2021.

Results Six patients presented with complaints compatible with ACNES. All of them were successfully managed with local injection therapy (n = 5) or pulsed radiofrequency (PRF) (n = 1).

Conclusions It appears that ACNES can be induced by endoscopy. Early recognition is important to avoid unnecessary diagnostics and delayed pain relief in patients. Most patients can be managed with local injection therapy.



Publication History

Received: 25 August 2021

Accepted: 14 December 2021

Article published online:
14 April 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Carnett J. Intercostal neuralgia as a cause of abdominal pain and tenderness. Surg Gyn Obstet 1926; 42: 625-632
    PubMedGoogle Scholar
  • 2 Scheltinga M, Roumen R. Anterior cutaneous nerve entrapment syndrome (ACNES). Hernia 2018; 22: 507-516
    CrossrefPubMedGoogle Scholar
  • 3 Jansen C, Bonouvrie D, Jacobs M. et al. Chronic abdominal pain after previous bariatric surgery: consider the abdominal wall. Obes Surg 2020; 30: 2942-2948
    CrossrefPubMedGoogle Scholar
  • 4 Boelens O, Scheltinga M, Houterman S. et al. Management of anterior cutaneous nerve entrapment syndrome in a cohort of 139 patients. Ann Surg 2011; 254: 1054-1058
    CrossrefPubMedGoogle Scholar
  • 5 Okamoto T, Fukuda K. Anterior cutaneous nerve entrapment syndrome occurring after endoscopy. Case Rep Gastroenterol 2020; 14: 377-382
    CrossrefPubMedGoogle Scholar
  • 6 Kuan LC, Li YT, Chen FM. et al. Efficacy of treating abdominal wall pain by local injection. Taiwan J Obstet Gynecol 2006; 45: 239-243
    CrossrefPubMedGoogle Scholar
  • 7 Takada T, Ikusaka M, Ohira Y. et al. Diagnostic usefulness of Carnett's test in psychogenic abdominal pain. Intern Med 2011; 50: 213-217
    CrossrefPubMedGoogle Scholar
  • 8 van Assen T, Brouns J, Scheltinga M. et al. Incidence of abdominal pain due to the anterior cutaneous nerve entrapment syndrome in an emergency department. Scand J Trauma Resusc Emerg Med 2015; 23: 19
    CrossrefPubMedGoogle Scholar
  • 9 Koop H, Koprdova S, Schürmann C. Chronic abdominal wall pain-a poorly recognized clinical problem. Dtsch Arztebl Int 2016; 113: 51-57
    PubMedGoogle Scholar
  • 10 Mol F, Heukelsfeldt Jansen C, Boelens O. et al. Adding steroids to lidocaine in a therapeutic injection regimen for patients with abdominal pain due to anterior cutaneous nerve entrapment syndrome (ACNES): a single blinded randomized clinical trial. Scand J Pain 2018; 18: 505-512
    CrossrefPubMedGoogle Scholar
  • 11 Maatman R, van Kuijk S, Steegers M. et al. A randomized controlled trial to evaluate the effect of pulsed radiofrequency as a treatment for anterior cutaneous nerve entrapment syndrome in comparison to anterior neurectomy. Pain Pract 2019; 19: 751-761
    CrossrefPubMedGoogle Scholar