A Síndrome de Pinçamento do Nervo Cutâneo Anterior (ACNES) é uma condição de dor crônica (que dura muito tempo) na parede da barriga, causada por problemas nos nervos. Ela ocorre quando as pequenas ramificações nervosas da frente (que vão para a pele), que vêm dos nervos localizados entre a 7ª e a 12ª costela, ficam pinçadas. Esse pinçamento geralmente acontece na lateral da "capa" de tecido que envolve o músculo reto abdominal (o principal músculo da barriga), na parte da frente. O resultado é uma dor muito forte e grande sensibilidade (dor ao toque) na área da pele afetada por esses nervos.
Introdução
O que você precisa saber de cara
A Síndrome de Pinçamento do Nervo Cutâneo Anterior (ACNES) é uma condição de dor crônica (que dura muito tempo) na parede da barriga, causada por problemas nos nervos. Ela ocorre quando as pequenas ramificações nervosas da frente (que vão para a pele), que vêm dos nervos localizados entre a 7ª e a 12ª costela, ficam pinçadas. Esse pinçamento geralmente acontece na lateral da "capa" de tecido que envolve o músculo reto abdominal (o principal músculo da barriga), na parte da frente. O resultado é uma dor muito forte e grande sensibilidade (dor ao toque) na área da pele afetada por esses nervos.
Escala de raridade
<1/50kMuito rara
1/20kRara
1/10kPouco freq.
1/5kIncomum
1/2k
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Publicações mais relevantes
Anterior cutaneous nerve entrapment syndrome (ACNES) disguised as recurrent abdominal pain: a diagnostic challenge with a simple solution.
Anterior cutaneous nerve entrapment syndrome (ACNES) is an under-recognised cause of chronic abdominal or chest wall pain in the era of increased reliance on diagnostic imaging and laboratory studies. We present the case of a man in his mid-60s who was hospitalised eight times over a 2-year period for unexplained abdominal pain despite extensive non-diagnostic workups. Careful re-examination, focusing on physical examination, demonstrated a positive Carnett's sign, leading to the diagnosis of ACNES. Ultrasound-guided trigger point injection with corticosteroid and local anaesthetic led to immediate symptom relief, confirming the diagnosis. This case highlights the diagnostic value of the physical exam and the need to consider ACNES in patients with persistent abdominal pain and normal imaging and laboratory studies, as early diagnosis can reduce symptom burden, prevent unnecessary testing and improve patient outcomes.
Children with suspected anterior cutaneous nerve entrapment syndrome (ACNES), it's not all the abdominal wall.
Anterior cutaneous nerve entrapment syndrome (ACNES) is a chronic pain syndrome that also occurs in children. The European Pain Federation EFIC recommends the application of the biopsychosocial model of pain. In children with suspected ACNES, the use of this model in diagnosis and treatment appears underused. Most publications focus on invasive interventions. These are potentially harming patients due to this one-dimensional approach. We aimed to assess the use of the biopsychosocial model during the diagnosis and treatment of children with chronic abdominal pain and suspected ACNES before referral to a tertiary paediatric pain centre (PPC) and diagnosis and treatment outcomes in the PPC using the biopsychosocial model. Single-centre retrospective cohort study of patients referred to a tertiary PPC with (suspected) diagnosis of ACNES between November 2017 and March 2024. Use of the biopsychosocial model and treatments performed before referral to the PPC. Confirmation of the diagnosis of ACNES on assessment and results of therapeutic interventions performed in the PPC. 31 patients were included. In less than 25% of the patients, the biopsychosocial model was used before referral. The treatments performed were diverse. At the PCC, in none of the cases could the diagnosis of ACNES be solidly confirmed. After treatment using the biopsychosocial model in the PPC, 20 patients (64.5%) reported less or absence of pain. Failure to use the biopsychosocial model in the treatment of suspected ACNES in children might lead to unnecessary invasive interventions with a risk of persistence of pain while the pain-maintaining factors are inadequately addressed. Therefore, a diagnostic-treatment algorithm is proposed.
Nerve Pathology in Children with Anterior Cutaneous Nerve Entrapment Syndrome.
Anterior cutaneous nerve entrapment syndrome (ACNES) is an underdiagnosed, but common, cause of abdominal pain in children. It is unknown if the involved nerves are normal or are pathologic and should be divided or released and retained. We present the pathology findings of resected nerves in children with ACNES. Operative reports, pathology reports, and clinical notes of consecutive patients who underwent anterior neurectomy from December 2011 to September 2023 were reviewed. One hundred and three pathology specimens from 78 patients were evaluated. Twenty-nine of the 103 specimens were from re-operative cases. Of the 103 pathology specimens, 71 (69%) had pathologic findings in the form of: myxomatous change (49, 69%), myelin vacuolar degeneration (22, 31%), perineural fibrosis (15, 21%), traumatic neuroma-like changes (2, 3%), and possible axonal injury (1, 1%). Four specimens (4%) did not have an identifiable nerve. The majority of nerve specimens from patients with ACNES were found to have changes consistent with chronic nerve damage distal to the location of presumed entrapment. Resection of these cutaneous nerves, rather than release and retention, seems prudent. III.
Management strategies for anterior cutaneous nerve entrapment syndrome: a scoping review.
Chronic Abdominal Wall Pain (CAWP) covers a broad spectrum of abdominal wall-related disorders, with Anterior Cutaneous Nerve Entrapment Syndrome (ACNES) being the most prevalent. Treatment strategies in published literature are limited and often not clearly outlined. This scoping review aims to outline current available literature about the management of ACNES, focusing on trigger point injections (TPI), pulsed radiofrequency (PRF) and surgical neurectomy. A systematic search in PubMed and EMBASE was performed until December 2024, in compliance with PRISMA guidelines. Articles concerning treatment for ACNES in adult patients were eligible. Data was collected on patient-reported outcomes using Numeric Rating Scale (NRS), Verbal Rating Scale (VRS) and EQ-5D-5 L scale. Success rate was determined as ≥ 50% NRS reduction and/or ≥ 2-point VRS reduction. A comprehensive search identified 18 records containing 3007 patients eligible for inclusion, including 7 randomized controlled trials (RCTs), 9 retrospective cohort studies and 2 retrospective case series. TPI has been considered as first step in the management of ACNES, offering both a diagnostic tool and a long-term success rate of 30%. PRF, as minimally invasive technique, tends to have a successful outcome in 20% with only a median temporary effect of 4 months. Surgical neurectomy provides long-term pain relief in 61%. Secondary surgery with anterior re-exploration or posterior neurectomy is long-term beneficial in 66% of refractory ACNES patients. The success rate for recurrent pain is significantly higher compared to residual pain after primary neurectomy. TPI, PRF and neurectomy are the cornerstones of ACNES treatment, often used in a three-step treatment algorithm. With an accurate diagnosis of ACNES, surgical neurectomy provides the best long-term effect on pain reduction. Future studies should standardize outcome measures, directing for a standardized step-up treatment algorithm in collaboration with pain specialists.
Correction to: Management strategies for anterior cutaneous nerve entrapment syndrome: a scoping review.
Publicações recentes
Abdominal wall pain syndromes: Alas! The lost art of clinical diagnosis.
Anterior cutaneous nerve entrapment syndrome (ACNES) disguised as recurrent abdominal pain: a diagnostic challenge with a simple solution.
Nerve Pathology in Children with Anterior Cutaneous Nerve Entrapment Syndrome.
Children with suspected anterior cutaneous nerve entrapment syndrome (ACNES), it's not all the abdominal wall.
📚 EuropePMC93 artigos no totalmostrando 106
Anterior cutaneous nerve entrapment syndrome (ACNES) disguised as recurrent abdominal pain: a diagnostic challenge with a simple solution.
BMJ case reportsNerve Pathology in Children with Anterior Cutaneous Nerve Entrapment Syndrome.
Pediatric and developmental pathology : the official journal of the Society for Pediatric Pathology and the Paediatric Pathology SocietyChildren with suspected anterior cutaneous nerve entrapment syndrome (ACNES), it's not all the abdominal wall.
BMJ paediatrics openManagement strategies for anterior cutaneous nerve entrapment syndrome: a scoping review.
Hernia : the journal of hernias and abdominal wall surgeryUltrasound-Guided Percutaneous Intercostal Cryoneurolysis for Anterior Cutaneous Nerve Entrapment Syndrome: A Case Report.
Pain medicine case reportsRedo-Posterior Neurectomy or Conservative Treatment for Recurrent Pain After Posterior Neurectomy in Anterior Cutaneous Nerve Entrapment Syndrome - A Case Comparison Analysis.
Journal of abdominal wall surgery : JAWSPeripheral nerve stimulation for the treatment of anterior cutaneous nerve entrapment syndrome: A case report and literature review.
Interventional pain medicineAnterior Cutaneous Nerve Entrapment Syndrome After Fotona Laser Skin Tightening Treatment: A Case Report.
Plastic surgery (Oakville, Ont.)Effectiveness of Ultrasound-Guided Hydrodissection for Atypical Anterior Cutaneous Nerve Entrapment Syndrome Presenting as Lower Back Pain Due to Retrograde Neuropathic Pain.
CureusA 76-year-old male with abdominal cutaneous nerve entrapment syndrome: a case report.
Frontiers in pain research (Lausanne, Switzerland)Anterior Cutaneous Nerve Entrapment Syndrome Triggered by Thoracic Compression Fracture and Weight Loss.
Internal medicine (Tokyo, Japan)Rectus sheath pulsed radiofrequency treatment for anterior cutaneous nerve entrapment syndrome: A case report.
SAGE open medical case reportsMultidisciplinary Management for Anterior Cutaneous Nerve Entrapment Syndrome (ACNES): A Case Series Including a Long COVID-19 Patient.
CureusCharacteristics of children presenting to the emergency department with anterior cutaneous nerve entrapment syndrome.
Pediatrics international : official journal of the Japan Pediatric Society[Comparison of two maneuvers to identify Carnett's sign in patients with chronic abdominal pain. Randomized controlled clinical trial].
Revista de gastroenterologia del Peru : organo oficial de la Sociedad de Gastroenterologia del PeruAtypical presentation of Skene's gland cyst.
BMJ case reportsAnterior Cutaneous Nerve Entrapment Syndrome Presenting as Chronic Abdominal Pain.
CureusDiagnostic Techniques for Posterior Cutaneous Nerve Entrapment Syndrome.
CureusHerpes zoster mimicking anterior cutaneous nerve entrapment syndrome.
BMJ case reportsA cross-sectional study of anterior cutaneous nerve entrapment syndrome at a Japanese emergency department.
Journal of general and family medicineLong-Term Efficacy of Posterior Neurectomy in Anterior Cutaneous Nerve Entrapment Syndrome.
Journal of abdominal wall surgery : JAWSUltrasound-guided peripheral nerve blocks for anterior cutaneous nerve entrapment syndrome after robot-assisted gastrectomy: A case report.
World journal of gastrointestinal surgeryA positive scratch collapse test in anterior cutaneous nerve entrapment syndrome indicates its neuropathic character.
Scandinavian journal of painPrecision Trigger Point Injections: An Anatomically Guided Approach for Anterior Cutaneous Nerve Entrapment Syndrome Treatment.
Internal medicine (Tokyo, Japan)Spectrum of abdominal anterior cutaneous nerve entrapment syndrome (ACNES) with successful management: a case report.
Journal of ultrasoundAnterior Cutaneous Nerve Entrapment Syndrome Caused by a Fixation Device: A Case Report.
A&A practiceLidocaine patch as noninvasive alternative treatment option in children with anterior cutaneous nerve entrapment syndrome: A retrospective case series.
Paediatric anaesthesiaPeripheral nerve stimulation (PNS): A valid and definitive therapeutical option for a case of anterior cutaneous nerve entrapment syndrome (ACNES).
Agri : Agri (Algoloji) Dernegi'nin Yayin organidir = The journal of the Turkish Society of AlgologyHow Do We Treat Children with Anterior Cutaneous Nerve Entrapment Syndrome and Is the Biopsychosocial Model Also Being Applied? A Scoping Review.
Pain research & managementThree Subtypes of Cutaneous Nerve Entrapment Syndrome: A Narrative Review.
Internal medicine (Tokyo, Japan)Anterior Cutaneous Nerve Entrapment Syndrome: An Underestimated Diagnosis.
CureusPulsed radiofrequency or surgery for anterior cutaneous nerve entrapment syndrome: Long-term results of a randomized controlled trial.
Pain practice : the official journal of World Institute of PainA Novel Approach to Assessing and Conservatively Treating Anterior Cutaneous Nerve Entrapment Syndrome: A Case Study.
CureusThe burden of abdominal pain after bariatric surgery in terms of diagnostic testing: the OPERATE study.
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Obesity surgeryVisceral symptoms in patients with anterior cutaneous nerve entrapment syndrome (ACNES): expression of viscerosomatic reflexes?
Hernia : the journal of hernias and abdominal wall surgeryLaparoscopic Surgical Options as a Minimally Invasive Procedure for a Patient With Recurrent Postoperative Pain in Anterior Cutaneous Nerve Entrapment Syndrome: A Case Report.
CureusA Combination of Three Nerve Entrapment Syndromes, Which was Difficult to Differentiate from a Vertebral Compression Fracture.
European journal of case reports in internal medicineUtilization of Truncal Fascial Plane Nerve Blocks for Chronic Pain Management: A Narrative Review.
Current pain and headache reportsAnterior cutaneous nerve entrapment syndrome in children.
Canadian family physician Medecin de famille canadienThe Scratch Collapse Test in patients diagnosed with Anterior Cutaneous Nerve Entrapment Syndrome (ACNES): A report of three cases.
International journal of surgery case reportsPulsed radiofrequency in a paediatric patient with disabling ACNES.
Revista espanola de anestesiologia y reanimacionA Case Report on Abdominal Pain Treated With a New Technique of Ultrasound-Guided Transversus Abdominis Plane Hydrodissection Using a Low Concentration of Local Anesthetics.
CureusThe role of a simple questionnaire predicting treatment success in children with ACNES.
Hernia : the journal of hernias and abdominal wall surgeryA case for ultrasound-guided peripheral nerve stimulation in intractable anterior cutaneous nerve entrapment syndrome.
Pain managementUltrasound Guided Nerve Blocks for Anterior Cutaneous Nerve Entrapment Syndrome an Overlooked Cause of Chronic Abdominal Pain: A Case Series.
Journal of Nepal Health Research CouncilNerve Identification Procedures Are Necessary for Complete Recovery From Recurrent Cases of Anterior Cutaneous Nerve Entrapment Syndrome: A Case Report.
Cureus[ANTERIOR CUTANEOUS NERVE ENTRAPMENT SYNDROME IN THE ABDOMINAL WALL].
HarefuahEndoscopy-induced anterior cutaneous nerve entrapment syndrome: a case series.
Endoscopy international openUltrasound-guided rectus sheath block for anterior cutaneous nerve entrapment syndrome after laparoscopic surgery: A case report.
World journal of clinical casesUltrasound-guided abdominal wall infiltration versus freehand technique in anterior cutaneous nerve entrapment syndrome (ACNES): randomized clinical trial.
BJS openDorsal root ganglion stimulation for patients with refractory pain due to anterior cutaneous nerve entrapment syndrome: A case series.
Pain practice : the official journal of World Institute of PainConservative treatment for an anterior cutaneous nerve entrapment syndrome case.
Pediatrics international : official journal of the Japan Pediatric SocietyDiagnostic Effect of Consultation Referral from Gastroenterologists to Generalists in Patients with Undiagnosed Chronic Abdominal Pain: A Retrospective Study.
Healthcare (Basel, Switzerland)[Anterior cutaneous nerve entrapment syndrome: a frequently overlooked cause of chronic abdominal pain in children].
Anales del sistema sanitario de NavarraPersistent pain relief following a single injection of a local anesthetic for neuropathic abdominal wall and groin pain.
Scandinavian journal of painConservative management of anterior cutaneous nerve entrapment syndrome: A case report.
Journal of bodywork and movement therapiesSurgical Management of Abdominal Anterior Cutaneous Nerve Entrapment Syndrome: Case Report, Surgical Technique, and Literature Review.
Plastic and reconstructive surgery. Global openKiteboarding Induced Abdominal Wall Pain: Intercostal Neuroma versus Anterior Cutaneous Nerve Entrapment (ACNES).
Plastic and reconstructive surgery. Global openCrowned Dens Syndrome Occurring after Endoscopic Submucosal Dissection for Early Gastric Cancer.
Case reports in gastroenterologyEndoscopic anisakis removal induced anterior cutaneous nerve entrapment syndrome.
BMJ case reportsRecurrent anterior cutaneous nerve entrapment syndrome (ACNES) in three consecutive pregnancies.
BMJ case reportsAnterior Cutaneous Nerve Entrapment Syndrome Occurring after Endoscopy.
Case reports in gastroenterologyAnterior Cutaneous Nerve Entrapment Syndrome: Two Case Reports of the Forgotten Diagnosis After Bariatric Surgery.
CureusTreatment strategies for anterior cutaneous nerve entrapment syndrome in children: A systematic review.
Journal of pediatric surgeryChronic Abdominal Pain After Previous Bariatric Surgery: Consider the Abdominal Wall.
Obesity surgeryHistopathologic examination of resected nerves from children with anterior cutaneous nerve entrapment syndrome: Clues for pathogenesis?
Journal of pediatric surgeryThe technique of cutaneous neurectomy for anterior cutaneous nerve entrapment syndrome.
Journal of pediatric surgeryDifficult differentiation of a somatic symptom disorder from anterior cutaneous nerve entrapment syndrome (ACNES): a case report.
BMC psychiatryAnterior cutaneous nerve entrapment syndrome.
BMJ case reports[Anterior cutaneous nerve entrapment syndrome].
Ugeskrift for laegerA Randomized Controlled Trial to Evaluate the Effect of Pulsed Radiofrequency as a Treatment for Anterior Cutaneous Nerve Entrapment Syndrome in Comparison to Anterior Neurectomy.
Pain practice : the official journal of World Institute of PainAbdominal Wall Pain or Irritable Bowel Syndrome: Validation of a Pediatric Questionnaire.
Journal of pediatric gastroenterology and nutritionCharacteristics of 1116 Consecutive Patients Diagnosed With Anterior Cutaneous Nerve Entrapment Syndrome (ACNES).
Annals of surgeryAnterior Cutaneous Nerve Entrapment Syndrome Possibly Triggered by Oral Contraceptives.
Internal medicine (Tokyo, Japan)Bilateral distribution of anterior cutaneous nerve entrapment syndrome (ACNES): are clinical features and outcomes comparable to unilateral ACNES?
Regional anesthesia and pain medicineAbdominal Wall Pain: Clinical Evaluation, Differential Diagnosis, and Treatment.
American family physicianFactors predicting outcome after anterior neurectomy in patients with chronic abdominal pain due to anterior cutaneous nerve entrapment syndrome (ACNES).
SurgeryProtracted diagnosis of ACNES: a costly exercise.
Journal of surgical case reportsRETRACTED: Quadratus lumborum block is not effective for anterior cutaneous nerve entrapment syndrome.
Journal of clinical anesthesiaAdding steroids to lidocaine in a therapeutic injection regimen for patients with abdominal pain due to anterior cutaneous nerve entrapment syndrome (ACNES): a single blinded randomized clinical trial.
Scandinavian journal of painPulsed Radiofrequency as a Minimally Invasive Treatment Option in Anterior Cutaneous Nerve Entrapment Syndrome: A Retrospective Analysis of 26 Patients.
Journal of clinical medicine researchAnterior Cutaneous Nerve Entrapment Syndrome in a Pediatric Patient Previously Diagnosed With Functional Abdominal Pain: A Case Report.
A&A practiceDiagnostic dilemma: think about anterior cutaneous nerve entrapment syndrome (ACNES) in patients with atypical abdominal pain and Crohn's disease.
BMJ case reportsDiagnostic characteristics of anterior cutaneous nerve entrapment syndrome in childhood.
European journal of pediatricsNeurectomy for anterior cutaneous nerve entrapment syndrome in children.
Journal of pediatric surgeryAnterior cutaneous nerve entrapment syndrome (ACNES).
Hernia : the journal of hernias and abdominal wall surgeryAnterior Cutaneous Nerve Entrapment Syndrome in Children: A Prospective Observational Study.
The Clinical journal of painAnterior cutaneous nerve entrapment syndrome with pain present only during Carnett's sign testing: a case report.
BMC research notesDRG Spinal Cord Stimulation as Solution for Patients With Severe Pain Due to Anterior Cutaneous Nerve Entrapment Syndrome: A Case Series.
Neuromodulation : journal of the International Neuromodulation SocietyTreatment response and central pain processing in Anterior Cutaneous Nerve Entrapment Syndrome: An explorative study.
Scandinavian journal of painPulsed radiofrequency or anterior neurectomy for anterior cutaneous nerve entrapment syndrome (ACNES) (the PULSE trial): study protocol of a randomized controlled trial.
TrialsAcute Appendicitis, Somatosensory Disturbances ("Head Zones"), and the Differential Diagnosis of Anterior Cutaneous Nerve Entrapment Syndrome (ACNES).
Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary TractChronic Localized Back Pain Due to Posterior Cutaneous Nerve Entrapment Syndrome (POCNES): A New Diagnosis.
Pain physicianAnterior rectus sheath blocks in children with abdominal wall pain due to anterior cutaneous nerve entrapment syndrome: a prospective case series of 85 children.
Paediatric anaesthesiaAnterior cutaneous nerve entrapment syndrome: management challenges.
Journal of pain researchAnterior neurectomy in children with a recalcitrant anterior cutaneous nerve entrapment syndrome is safe and successful.
Journal of pediatric surgeryChronic Abdominal Wall Pain: An Under-Recognized Diagnosis Leading to Unnecessary Testing.
Journal of clinical gastroenterologyAn umbilical surprise: a collective review on umbilical pilonidal sinus : An uncommon alternative diagnosis in common umbilical symptoms.
Hernia : the journal of hernias and abdominal wall surgeryTransversus abdominal plane and rectus sheath block combination for intractable anterior cutaneous nerve entrapment syndrome after severe cholecystitis.
Journal of clinical anesthesiaAnterior cutaneous nerve entrapment syndrome following an appendectomy: case report.
Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical NeurophysiologyAnterior cutaneous nerve entrapment syndrome: an unusual cause of abdominal pain during pregnancy.
International journal of obstetric anesthesiaUltrasound Guided Transversus Abdominis Plane Block for Anterior Cutaneous Nerve Entrapment Syndrome.
The Korean journal of painIntraperitoneal onlay mesh reinforcement of the abdominal wall: a new surgical option for treatment of anterior cutaneous nerve entrapment syndrome-a retrospective cohort analysis of 30 consecutive patients.
Surgical endoscopyPrevalence of Anterior Cutaneous Nerve Entrapment Syndrome in a Pediatric Population With Chronic Abdominal Pain.
Journal of pediatric gastroenterology and nutritionIncidence of abdominal pain due to the anterior cutaneous nerve entrapment syndrome in an emergency department.
Scandinavian journal of trauma, resuscitation and emergency medicineAssociações
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Referências e fontes
Bases de dados externas citadas neste artigo
Publicações científicas
Artigos indexados no PubMed ligados a esta doença no grafo RarasNet — título, periódico e PMID direto da fonte, sem intermediação de IA.
- Anterior cutaneous nerve entrapment syndrome (ACNES) disguised as recurrent abdominal pain: a diagnostic challenge with a simple solution.
- Children with suspected anterior cutaneous nerve entrapment syndrome (ACNES), it's not all the abdominal wall.
- Nerve Pathology in Children with Anterior Cutaneous Nerve Entrapment Syndrome.Pediatric and developmental pathology : the official journal of the Society for Pediatric Pathology and the Paediatric Pathology Society· 2026· PMID 41721538mais citado
- Management strategies for anterior cutaneous nerve entrapment syndrome: a scoping review.
- Correction to: Management strategies for anterior cutaneous nerve entrapment syndrome: a scoping review.
- Abdominal wall pain syndromes: Alas! The lost art of clinical diagnosis.
Bases de dados e fontes oficiais
Identificadores e referências canônicas usadas para montar este verbete.
- ORPHA:51890(Orphanet)
- MONDO:0018873(MONDO)
- GARD:18843(GARD (NIH))
- Busca completa no PubMed(PubMed)
- Q19765925(Wikidata)
Dados compilados pelo RarasNet a partir de fontes abertas (Orphanet, OMIM, MONDO, PubMed/EuropePMC, ClinicalTrials.gov, DATASUS, PCDT/MS). Este conteúdo é informativo e não substitui avaliação médica.
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