Sigrid Bairdain1, Pradeep Dinakar2, David P Mooney3. 1. Department of Pediatric Surgery, Boston Children's Hospital, Boston, MA, USA. Electronic address: Sigrid.bairdain@childrens.harvard.edu. 2. Department of Anesthesia, Boston Children's Hospital, Boston, MA, USA. 3. Department of Pediatric Surgery, Boston Children's Hospital, Boston, MA, USA.
Abstract
PURPOSE: The purpose of this manuscript is to report on an entity known as Anterior Cutaneous Nerve Entrapment Syndrome (ACNES) and its relevance to chronic abdominal pain encountered in children. METHODS: Following institutional review board approval, we retrospectively reviewed patients who underwent operation for presumed ACNES from 2011-2014. Variables reviewed included age, gender, age at surgery, time from onset of pain to surgery, additional medical treatments, and surgery performed. The main outcome measure was amelioration of pain. RESULTS: Nine patients met the study criteria whereby 7 were female and 2 were male patients. Median age at time of surgery was 14 years (range: 10-19 years) and time from onset of symptoms to surgery was 10 months (range: 0.5-60 months). Eight reported complete resolution of the original symptoms in follow-up appointments. One patient reported new, yet similar symptoms on her opposite trunk. CONCLUSION: ACNES is a reported cause of chronic abdominal pain that can be managed surgically in the pediatric patient once medical management has been optimized. Close collaboration between surgeons and pain specialists helps identify patients who will benefit from surgical interventions and consideration of this condition could result in more timely pain relief in children. Further studies on a larger scale are needed to determine the long-term outcomes of this procedure.
PURPOSE: The purpose of this manuscript is to report on an entity known as Anterior Cutaneous Nerve Entrapment Syndrome (ACNES) and its relevance to chronic abdominal pain encountered in children. METHODS: Following institutional review board approval, we retrospectively reviewed patients who underwent operation for presumed ACNES from 2011-2014. Variables reviewed included age, gender, age at surgery, time from onset of pain to surgery, additional medical treatments, and surgery performed. The main outcome measure was amelioration of pain. RESULTS: Nine patients met the study criteria whereby 7 were female and 2 were male patients. Median age at time of surgery was 14 years (range: 10-19 years) and time from onset of symptoms to surgery was 10 months (range: 0.5-60 months). Eight reported complete resolution of the original symptoms in follow-up appointments. One patient reported new, yet similar symptoms on her opposite trunk. CONCLUSION: ACNES is a reported cause of chronic abdominal pain that can be managed surgically in the pediatric patient once medical management has been optimized. Close collaboration between surgeons and pain specialists helps identify patients who will benefit from surgical interventions and consideration of this condition could result in more timely pain relief in children. Further studies on a larger scale are needed to determine the long-term outcomes of this procedure.