Fascial Tear in the Medial Rectus Abdominis Muscle Leading to Anterior Cutaneous Nerve Entrapment Syndrome

Abstract

Background: Although anterior cutaneous nerve entrapment syndrome (ACNES) classically presents with nerve entrapment along the lateral edge of the rectus abdominis, fascial tears can result in ACNES presenting in other locations within the muscle. Case Report: Over 4 years, a 26-year-old woman had undergone numerous tests to find and treat the cause of her debilitating abdominal pain. She presented to our clinic, in January 2021, with a history of nausea, vomiting, and shooting epigastric pain. Diagnostic anterior and posterior abdominal wall exploration was performed and a percutaneous nerve was entrapped in a fascial tear of the medial rectus abdominis muscle. Conclusions: This case report highlights that: ACNES can present at locations other than the lateral border of the rectus abdominis; ACNES is a common and curable cause of serious chronic abdominal pain; and knowledge of this pathology has yet to permeate into most of the medical community leading to detrimental outcomes for patients. Key words: ACNES, abdominal pain, anterior neurectomy, chronic pain, Carnett’s test