Abdominal cutaneous nerve entrapment syndrome

Chronic abdominal pain is a frequently presenting condition in the pain clinics. Patients have often undergone a plethora of investigations, including diagnostic surgery and psychiatric review, before referral to Pain Management Services. Ongoing pain leads to development of central sensitization, which is heightened sensitivity to pain and touch, because of the effect of persistent pain on the neuroplasticity of the central nervous system. It can result in significant anxiety, distress, and loss of work days for the patient. Up to 30% of patients with chronic abdominal pain have pain originating in the abdominal wall 1,2 and abdominal cutaneous nerve entrapment syndrome (ACNES) is the most frequent cause of pain in these cases. 3 This diagnosis can be established from the patient’s history, physical examination, and positive response to local anaesthetic injection. 4 More awareness among clinicians of the abdominal cutaneous nerve entrapment syndrome could lead to earlier diagnosis and prevent the consequences of prolonged investigation and pain.