Anterior Cutaneous Neurectomy—Child's Play?

Abstract

Chronic abdominal pain (CAP) is a common entity in the pediatric population and has an extensive differential diagnosis. Anterior cutaneous nerve entrapment syndrome (ACNES) is an etiology that is not often diagnosed and requires an individualized approach. Treatment options for ACNES include nonsurgical and surgical, often a graded approach is used. A 12-year-old boy presented with CAP, and was extensively evaluated as well as underwent multiple abdominal surgeries. He was eventually diagnosed with ACNES and underwent a trial conservative management. Although he initially showed improvement, his pain returned. He later underwent a neurectomy procedure with significant postoperative relief. The patient experienced significant relief postprocedure. He experienced up to 70% relief in pain in the immediate postoperative period and at the end of 3 months, pain was completely absent. The patient was able to return to all his activities including active sports. The diagnosis and management of ACNES is a challenging condition, but this report seeks to highlight its importance as an unusual cause. Literature on the management of this condition is scarce, making it difficult to make informed decisions. Surgical neurectomy is seen as a favored procedure for children with moderate-good pain relief, especially for those who do not respond satisfactorily to local blocks.

Keywords

abdominal pain - nerve compression syndromes - denervation - child

Patient Consent

Informed consent was not necessary as there is no identifying information of the patient and the retrospective nature of the study.

Ethical Approval

Research involving human subjects complied with all relevant national regulations, institutional policies, and is in accordance with the tenets of the Helsinki Declaration (as amended in 2013), and has been approved by the Institutional Review Board as not requiring clearance as the study is based on retrospective chart review without any identifying patient characteristics.

Authors' Contributions

All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

Publication History

Received: 24 October 2023

Accepted: 12 June 2024

Article published online:
09 August 2024

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