title: Surgery for abdominal wall pain caused by cutaneous nerve entrapment in children-a single institution experience in the last 5 years.
abstract: BACKGROUND
  Chronic abdominal pain (CAP) is a serious medical condition which needs to be approached with great attention. Chronic abdominal pain may be caused by entrapment of cutaneous branches of intercostal nerves (ACNES).
  
  
  OBJECTIVE
  The aim of this study is the surgery for abdominal wall pain which caused by cutaneous nerve entrapment in children during last 5 years.
  
  
  METHODS
  In all children with ACNES, we tried conservative treatment with anesthetic and steroid injections. In children who were refractory to conservative treatment, we received surgical procedure like sectioning the entrapped nerve to obtain relief.
  
  
  RESULTS
  In 12 pediatric patients with chronic abdominal pain, we diagnosed ACNES. Each presented with abdominal pain and a positive Carnett sign. Local nerve blocks using anesthetic and steroid injections are the treatment. In all patients, we tried with local nerve block. In 3 patients, pain improvement occurs in the few minutes, and they were without pain after 5 days. In other 4 patients required a reinjection for pain recurrence. In one patients pain was gone. The maximum reinjection was 3. In other 5 patients, we did operative treatment like sectioning the entrapped nerve.
  
  
  CONCLUSIONS
  Some children with CAP have ACNES. In all children with ACNES, we recommended local nerve blocks. If the local block in 3 times is not helping, neurectomy of the peripheral nerve is method of choice.
authors.affiliation: Department of Pediatric Surgery, Medical School Zagreb, Zagreb, Croatia.
authors.forename: Mirko
authors.initials: M
authors.lastname: Zganjer
authors.forename: Davor
authors.initials: D
authors.lastname: Bojić
authors.forename: Igor
authors.initials: I
authors.lastname: Bumči
keywords: Abdominal Pain; Child; Propionibacterium Acnes