Prevalence of Anterior Cutaneous Nerve Entrapment Syndrome in a Pediatric Population With Chronic Abdominal Pain.
OBJECTIVE
Anterior cutaneous nerve entrapment syndrome (ACNES) is a frequently overlooked condition causing chronic abdominal pain (CAP). The objective of the present study was to investigate the rate of ACNES in a pediatric outpatient cohort with CAP.


METHODS
A cross-sectional cohort study was conducted in a population 10 to 18 years of age consulting a pediatric outpatient department with new-onset CAP during a 2 years' time period. All individuals were identified through a standard hospital registration system. History, physical examination, diagnosis, and success of treatment were obtained in patients who were diagnosed as having ACNES.


RESULTS
Twelve of 95 adolescents with CAP were found to be experiencing ACNES. Carnett sign was positive at the lateral border of the rectus abdominus muscle in all 12. Altered skin sensation was present in 11 of 12 patients with ACNES. Six weeks after treatment (1-3 injections, n = 5; neurectomy, n = 7), pain was absent in 11 patients.


CONCLUSIONS
ACNES is present in 1 of 8 adolescents presenting with CAP to a pediatric outpatient department of a teaching hospital. Simple physical examinational testing allows for the diagnosis. Treatments including nerve blocks or surgery are beneficial in most.
*Solvimáx, Center of Excellence for Abdominal Wall and Groin Pain, Department of Surgery †Department of Pediatrics, Máxima Medical Center, Veldhoven, The Netherlands.
Murid
M
Siawash
Jenneke W A
JW
de Jager-Kievit
Walther Tjon A
WT
Ten
Rudi M
RM
Roumen
Marc R
MR
Scheltinga
D015746:Abdominal Pain / Q000188:drug therapy / Q000453:epidemiology*; D000293:Adolescent; D002648:Child; D059350:Chronic Pain / Q000188:drug therapy / Q000453:epidemiology*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D008012:Lidocaine / Q000627:therapeutic use*; D008297:Male; D009408:Nerve Compression Syndromes / Q000175:diagnosis / Q000453:epidemiology*; D010147:Pain Measurement; D015995:Prevalence; D016896:Treatment Outcome
D005938:Glucocorticoids; D008012:Lidocaine