G Oliván-Gonzalvo, J Ruiz-Serrano, P Uclés-Moreno, A Fernández-Sanz
{"title":"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。","authors":"G Oliván-Gonzalvo, J Ruiz-Serrano, P Uclés-Moreno, A Fernández-Sanz","doi":"10.23938/ASSN.0952","DOIUrl":null,"url":null,"abstract":"<p><p>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.</p>","PeriodicalId":7775,"journal":{"name":"Anales Del Sistema Sanitario De Navarra","volume":null,"pages":null},"PeriodicalIF":1.0000,"publicationDate":"2021-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/08/86/assn-44-02-303.PMC10019533.pdf","citationCount":"1","resultStr":"{\"title\":\"[Anterior cutaneous nerve entrapment syndrome: a frequently overlooked cause of chronic abdominal pain in children].\",\"authors\":\"G Oliván-Gonzalvo, J Ruiz-Serrano, P Uclés-Moreno, A Fernández-Sanz\",\"doi\":\"10.23938/ASSN.0952\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>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.</p>\",\"PeriodicalId\":7775,\"journal\":{\"name\":\"Anales Del Sistema Sanitario De Navarra\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.0000,\"publicationDate\":\"2021-08-20\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/08/86/assn-44-02-303.PMC10019533.pdf\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Anales Del Sistema Sanitario De Navarra\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.23938/ASSN.0952\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Anales Del Sistema Sanitario De Navarra","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.23938/ASSN.0952","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
[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.
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.