Jelmer E Oor1, Çagdas Ünlü2, Eric J Hazebroek2. 1. Department of Surgery, St. Antonius Hospital, Koekoekslaan 1, Nieuwegein, 3430VB, The Netherlands. Electronic address: j.oor@antoniusziekenhuis.nl. 2. Department of Surgery, St. Antonius Hospital, Koekoekslaan 1, Nieuwegein, 3430VB, The Netherlands.
Abstract
BACKGROUND: Abdominal cutaneous nerve entrapment syndrome (ACNES) is a frequently overlooked cause of chronic abdominal pain. We aim to outline the current available literature concerning the treatment of patients diagnosed with ACNES. DATA SOURCES: A systematic search in PubMed, EMBASE, CINAHL, and Cochrane databases was performed. Seven studies were included; describing trigger point injection (TPI) or anterior neurectomy as stand-alone procedure, TPI followed by anterior neurectomy as stepwise regimen, and nerve stimulation and phenolization. After TPI, 86% of the patients showed successful response, 76% at long-term follow-up. Two other studies report successful treatment in 50% of patients. In the included trial using anterior neurectomy, 73% vs 18% of the patients demonstrate a successful pain response in the neurectomy and sham group, respectively. Two cohort studies showed that 69% and 61% of the neurectomy group reported to be satisfied at 18 months and 32 months follow-up, respectively. CONCLUSIONS: There is significant pain relief after injections and anterior neurectomy. Awareness of the diagnosis is important. The validity of currently used diagnostic criteria needs to be evaluated in additional studies.
BACKGROUND:Abdominal cutaneous nerve entrapment syndrome (ACNES) is a frequently overlooked cause of chronic abdominal pain. We aim to outline the current available literature concerning the treatment of patients diagnosed with ACNES. DATA SOURCES: A systematic search in PubMed, EMBASE, CINAHL, and Cochrane databases was performed. Seven studies were included; describing trigger point injection (TPI) or anterior neurectomy as stand-alone procedure, TPI followed by anterior neurectomy as stepwise regimen, and nerve stimulation and phenolization. After TPI, 86% of the patients showed successful response, 76% at long-term follow-up. Two other studies report successful treatment in 50% of patients. In the included trial using anterior neurectomy, 73% vs 18% of the patients demonstrate a successful pain response in the neurectomy and sham group, respectively. Two cohort studies showed that 69% and 61% of the neurectomy group reported to be satisfied at 18 months and 32 months follow-up, respectively. CONCLUSIONS: There is significant pain relief after injections and anterior neurectomy. Awareness of the diagnosis is important. The validity of currently used diagnostic criteria needs to be evaluated in additional studies.