前皮神经卡压综合征:儿童慢性腹痛的一个经常被忽视的原因。

IF 1 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
G Oliván-Gonzalvo, J Ruiz-Serrano, P Uclés-Moreno, A Fernández-Sanz
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引用次数: 1

摘要

前皮神经卡压综合征(ACNES)在慢性腹痛(CAP)的鉴别诊断中经常被忽视。一名11岁的CAP男孩先前在急诊和消化服务中进行了研究,但未发现器质性病理,提示心身起源。检查时,他显示腹壁疼痛位于Th11肋间神经末梢分支区域,Carnett征象阳性,在触发点注射局麻药反应良好。体感诱发电位显示右侧前直肌神经病变。他被诊断为ACNES。作为治疗,超声引导下筋膜下注射利多卡因和地塞米松到触发点。四个月后,他仍无症状。对于儿科ACNES患者的治疗,应采用循序渐进的策略,从触发点注射利多卡因和地塞米松开始,对注射效果有限的病例保留前神经切除术。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

[Anterior cutaneous nerve entrapment syndrome: a frequently overlooked cause of chronic abdominal pain in children].

[Anterior cutaneous nerve entrapment syndrome: a frequently overlooked cause of chronic abdominal pain in children].

[Anterior cutaneous nerve entrapment syndrome: a frequently overlooked cause of chronic abdominal pain in children].

Anterior cutaneous nerve entrapment syndrome (ACNES) is often overlooked in the differential diagnosis of chronic abdominal pain (CAP). An 11-year-old boy with CAP previously studied in emergency and digestive services without detecting organic pa-thology, suggesting a psychosomatic origin. On examination, he showed pain in the abdominal wall located to the area of the terminal branch of the Th11 intercostal nerve, with a positive Carnett's sign and a favorable response to injection with local anesthetic at the trigger point. Somatosensory evoked potentials revealed right anterior rectus nerve neuropathy. He was diagnosed with ACNES. As treatment, an ultrasound-guided subfascial injection with lidocaine and dexame-thasone into the trigger point was administered. After four months, he remains asymptomatic. For the treatment of ACNES in pediatrics patients, a step-up strategy should be applied, starting with trigger point in-jections of lidocaine and dexamethasone and reserving anterior neurectomy for those cases with limited effect of these injections.

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来源期刊
Anales Del Sistema Sanitario De Navarra
Anales Del Sistema Sanitario De Navarra 医学-公共卫生、环境卫生与职业卫生
CiteScore
1.30
自引率
30.00%
发文量
88
审稿时长
>12 weeks
期刊介绍: La revista Anales del Sistema Sanitario de Navarra es una revista de contenido médico sanitario de carácter generalista. En ella tienen cabida artículos referidos a temas de salud/enfermedad en general, salud pública, administración y gestión sanitaria y Atención Primaria de salud.
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