Dr. Amod Manocha - Pain Specialist In Delhi
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 Abdominal Treatment In Delhi

Abdominal Pain

March 25, 2018

Anterior Cutaneous Nerve Entrapment Syndrome (Acnes)

Anterior Cutaneous Nerve Entrapment Syndrome (Acnes)

Chronic abdominal pain is a common reason for seeking medical attention. Pain generators in abdominal pain are not always easy to identify and may be located inside the abdomen, in the abdominal wall or in the nearby organs with pain being referred to the abdomen. ACNES is a common cause of abdominal wall pain and it involves entrapment of small nerves which supply the skin of abdominal wall as they pass through the abdominal muscle (lateral part of rectus muscle). A study from a Dutch teaching hospital found approximately 2% of patients presenting to emergency department with acute abdominal pain suffered from ACNES.

ACNES presents as localized unilateral abdominal pain and patients can usually pinpoint painful areas close to the middle of abdomen. Pain may be provoked by position change or tensing of abdominal muscles and is generally independent of food intake, bowel habits. Trauma or previous surgery can also contribute to the entrapment of these small nerves. Abdominal wall pain is frequently unrecognized and this often leads to a magnitude of investigations, specialist consultations, prolonged suffering, overtreatment and inefficient utilization of resources.

Ultrasound guided injections are used to confirm the diagnosis of ACNES and provide pain relief. Ultrasound guidance can not only help in identifying local but also helps in improving the accuracy and safety of injections. Sometimes repeat injections are required to provide sustained pain relief. I have successfully identified and treated ACNES on numerous occasions- most often after local trauma or surgeries such as caesarean section, open/ laparoscopic abdominal surgeries etc.

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Dr. Amod Manocha - Pain specialist doctor in Delhi

Dr. Amod Manocha

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