2017 Volume 53 Issue 6 Pages 1200-1205
Chronic abdominal wall pain is frequently misdiagnosed as arising from a visceral source, often resulting in inappropriate diagnostic testing, unsatisfactory treatment, and considerable cost. The most common cause appears to be anterior cutaneous nerve entrapment syndrome (ACNES). Carnett’s sign (accentuated localized tenderness with abdominal wall tensing) is a helpful diagnostic sign. We report a case of the prompt and successful treatment of ACNES with iliohypogastric nerve resection. An 8-year-old boy presenting with right chronic groin pain for more than 1 month was suspected of having inguinal hernia by an orthopedic surgeon. He showed tenderness on the right groin area, accompanied by the Carnett sign. Iliohypogastric nerve resection resulted in complete pain relief. Therefore, we diagnosed him as having ACNES originating from the anterior cutaneous branches of the iliohypogastric nerve. ACNES is a relatively unknown cause of abdominal pain; however, the diagnosis and treatment of ACNES are simple. For the clinical care of chronic abdominal pain, a therapist should always consider ACNES. Awareness of ACNES might increase diagnostic accuracy when evaluating patients with chronic abdominal pain.
