Abstract
BackgroundThe identification of anterior cutaneous nerve entrapment syndrome is often challenging, due to no widely accepted standard guidelines regarding laboratory and imaging tests for the diagnosis of ACNES.Case presentationA 77-year-old Japanese man presented with mild lower abdominal pain that had been present for the past 3 years. Physical examination revealed no abdominal pain during palpation, with normal laboratory and imaging testing; therefore, conservative therapy was initiated. However, the abdominal pain continued. Re-examination 16 days later revealed three tender points in accordance with intercostal nerves Th10, Th11, and Th12, with the pain occurring only during Carnett’s sign testing. A cutaneous injection of 1% lidocaine was administered, and the abdominal pain was resolved about 30 min later. Based on these results, anterior cutaneous nerve entrapment syndrome was diagnosed.ConclusionsIt is sometimes hard to diagnose anterior cutaneous nerve entrapment syndrome without testing for Carnett’s sign. If patients present with chronic abdominal pain, clinicians should test for Carnett’s sign even if no pain is elicited during regular abdominal palpation.
Highlights
The identification of anterior cutaneous nerve entrapment syndrome is often challenging, due to no widely accepted standard guidelines regarding laboratory and imaging tests for the diagnosis of Anterior cutaneous nerve entrapment syndrome (ACNES).Case presentation: A 77-year-old Japanese man presented with mild lower abdominal pain that had been present for the past 3 years
If patients present with chronic abdominal pain, clinicians should test for Carnett’s sign even if no pain is elicited during regular abdominal palpation
Anterior cutaneous nerve entrapment syndrome (ACNES) is a condition in which chronic or intermittent abdominal wall pain is caused by irritation of the cutaneous nerve roots passing through the abdominal fascia [1]
Summary
We experienced a case of ACNES in which the pain was present only during Carnett’s sign testing. If patients present with localized chronic or intermittent abdominal pain with normal laboratory or imaging results, physicians should check for Carnett’s sign even if no abdominal tenderness is identified by regular abdominal palpation. Abbreviation ACNES: anterior cutaneous nerve entrapment syndrome. Authors’ contributions RT was responsible for the patient and wrote the paper. Both authors read and approved the final manuscript. Author details 1 Department of Community Medicine, Nabari, Mie University Graduate School of Medicine, Tsu, Mie, Japan. 3 Department of Family Medicine, Mie University School of Medicine and Graduate School of Medicine, Tsu, Mie, Japan
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