Anterior cutaneous nerve entrapment syndrome: an unusual cause of abdominal pain during pregnancy

Roderick, E.; Norman, B.

doi:10.1016/j.ijoa.2015.09.004

Cited by 7 publications

(5 citation statements)

References 3 publications

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“…Systemic drug administration is usually the first line of treatment for various chronic pain syndromes,12–13 including the cases of a nerve injury that causes neuropathic pain. However, in patients with ACNES, the systemic drug therapy is not so effective, mostly as the etiology of nerve irritation is mechanical.…”

Section: Systemic Drug Administrationmentioning

confidence: 99%

“…The most commonly administered drugs were nonsteroidal anti-inflammatory drugs (NSAIDs) such as paracetamol, weak opioids, and drugs generally used for neuropathic pain management, such as antiepileptics (gabapentin and pregabalin) and antidepressants (mostly amitriptyline) 12. Roderick and Norman13 used amitriptyline and lidocaine patches combined with paracetamol and tramadol, which gave good results, while Imajo et al14 reported the administration of pregabalin, which was only partially effective. Sahoo and Nair15 detailed the administration of NSAIDs, muscle relaxants, tramadol, and gabapentin in two patients, but this did not result in any significant relief.…”

Section: Systemic Drug Administrationmentioning

confidence: 99%

“…However, the management of other conditions of chronic pain suggests that systemic drug administration may be used as a first step or in combination with interventional techniques, in order to facilitate patients’ recovery and improve their overall quality of life 13,17,18. Systemic pharmacotherapy must follow the World Health Organization’s analgesic ladder in addition to the guidelines for neuropathic pain management, and this may be used in the course of a multimodal and individualized management plan 17,18…”

Section: Systemic Drug Administrationmentioning

confidence: 99%

“…Interventional techniques were the main therapeutic option employed in most of the studies on pain management in ACNES 1,2,13,14,17–20. These techniques include the trigger point injections (blind or ultrasound-guided), neurolytic techniques (chemical neurolysis or radiofrequency ablation), surgical techniques (anterior neurectomy and mesh reinforcement), and newer techniques such as botulinum toxin injection and neuromodulation 1,2,10–12…”

Section: Interventional Techniquesmentioning

confidence: 99%

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Anterior cutaneous nerve entrapment syndrome: management challenges

Chrona¹,

Kostopanagiotou²,

Damigos³

et al. 2017

JPR

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Anterior cutaneous nerve entrapment syndrome (ACNES) is a commonly underdiagnosed and undertreated chronic state of pain. This syndrome is characterized by the entrapment of the cutaneous branches of the lower thoracoabdominal intercostal nerves at the lateral border of the rectus abdominis muscle, which causes severe, often refractory, chronic pain. This narrative review aims to identify the possible therapeutic strategies for the management of the syndrome. Seventeen studies about ACNES therapy were reviewed; of them, 15 were case–control studies, case series, or case reports, and two were randomized controlled trials. The presently available management strategies for ACNES include trigger point injections (diagnostic and therapeutic), ultrasound-guided blocks, chemical neurolysis, and surgical neurectomy, in combination with systemic medication, as well as some emerging techniques, such as radiofrequency ablation and neuromodulation. An increased awareness of the syndrome and the use of specific diagnostic criteria for its recognition are required to facilitate an early and successful management. This review compiles the proposed management strategies for ACNES.

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Section: Systemic Drug Administrationmentioning

confidence: 99%

Section: Systemic Drug Administrationmentioning

confidence: 99%

Section: Systemic Drug Administrationmentioning

confidence: 99%

Section: Interventional Techniquesmentioning

confidence: 99%

See 2 more Smart Citations

Anterior cutaneous nerve entrapment syndrome: management challenges

Chrona¹,

Kostopanagiotou²,

Damigos³

et al. 2017

JPR

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“…As the growing gravid uterus exits the pelvic cavity at 12 weeks' gestation, it is logical that a pain condition related to the displacement of the nerves of the abdominal wall could be provoked by pregnancy. To date, only single case reports of AWP in pregnancy have been published (9)(10)(11)(12). We are currently writing a case series of our successful treatment of 20 pregnant patients at our hospital with AWP over the last 18 months.…”

Section: *Unpublished Datamentioning

confidence: 99%

Unexplained abdominal pain in pregnancy and the use of the term ‘Round Ligament Pain’: a single-centre New Zealand pilot cohort study

Twidale¹,

Ahmad²,

Halpin³

et al. 2022

Preprint

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Background: Unexplained abdominal pain (UAP) in pregnancy is common, can be severe and difficult to treat. Despite no supportive evidence, it is often called ‘Round Ligament Pain’ (RLP). Abdominal Wall Pain (AWP) is under-recognised but is simple to diagnose and treat. We aim to display that UAP is common and that without evidence, medical carers continue to cite RLP and to show that pregnant people with UAP frequently use descriptors shared by AWP. Methods: We performed a prospective, cross-sectional, observational pilot cohort of an antenatal clinic in New Zealand. 203 pregnant adults over 20 weeks’ gestation were interviewed via written questionnaire. Measurements included the proportion with UAP, recognition of the term RLP and whether participants reported that medical carers taught them about RLP. Participants were asked whether their UAP fit any of fourteen descriptors, eleven of which were suggestive of AWP. Results: The majority of participants had UAP in pregnancy (68.5%). Recognition of the term RLP was high (54%). Those with UAP had an odds ratio of 9.23 of citing a medical carer as their RLP information source when compared to those without pain (95% CI 3.5-24.4). Amongst the participants who reported UAP, 98.6% used descriptors shared by AWP. The commonest AWP descriptors were abdominal pain that was: ‘worsened by walking, bending, moving to sit’ (72.6%); ‘sharp’ (56.8%); and ‘always in the same location’ (45.3%). Conclusions: UAP in pregnancy is common and our participants report that medical carers continue to cite RLP. Their unexplained abdominal pain shared many historical features with AWP.

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