A 26 years old primigravida woman presented with abdominal cutaneous entrapment syndrome: a case report
Dublin Core
Title
A 26 years old primigravida woman presented with abdominal cutaneous entrapment syndrome: a case report
Subject
ACNES, Neuropathic pain, Pregnancy
Description
Abstract
Background Abdominal cutaneous nerve entrapment syndrome (ACNES) is characterized by severe, mostly
refractory, chronic pain due to the entrapment of the cutaneous branches of the lower torso intercostal nerves at
the lateral edge of the rectus abdominis muscle. ACNES is rare compared to other pregnancy-related peripheral
neuropathies and is often overlooked as a differential diagnosis for abdominal pain, despite the diagnosis relying
primarily on patient history and physical examination. Emergency physicians and other medical personnel’s lack of
exposure to such cases results in unnecessary laboratory requests, repeated visits, and increased fear and tension for
the patient.
Case presentation A 26-year-old primigravida on her second trimester of pregnancy presented to our Emergency
department with persistent localized right upper quadrant abdominal pain. Despite repeated visit to the nearby
hospital, no diagnosis was settled and the pain persisted. At our ED after a thorough history, physical examination and
diagnostic test no abnormality was found. Finally Abdominal cutaneous nerve entrapment syndrome (ACNES) was
considered and a mixture of 1 ml 2% lidocaine with adrenaline and 1 ml dexamethasone (4 mg) was infiltrated into
the fascial plane in a fanning fashion into the most tender area using a modified technique and the patient reported
significant improvement in pain.
Conclusion Abdominal cutaneous nerve entrapment syndrome (ACNES) is a cause of abdominal pain in pregnancy
that is often overlooked. The objective of this study is to describe a rare case of ACNES in a 26-year-old primigravida
woman who presented to a low-resource emergency department to assist patient management.
Keywords ACNES, Neuropathic pain, Pregnancy
Background Abdominal cutaneous nerve entrapment syndrome (ACNES) is characterized by severe, mostly
refractory, chronic pain due to the entrapment of the cutaneous branches of the lower torso intercostal nerves at
the lateral edge of the rectus abdominis muscle. ACNES is rare compared to other pregnancy-related peripheral
neuropathies and is often overlooked as a differential diagnosis for abdominal pain, despite the diagnosis relying
primarily on patient history and physical examination. Emergency physicians and other medical personnel’s lack of
exposure to such cases results in unnecessary laboratory requests, repeated visits, and increased fear and tension for
the patient.
Case presentation A 26-year-old primigravida on her second trimester of pregnancy presented to our Emergency
department with persistent localized right upper quadrant abdominal pain. Despite repeated visit to the nearby
hospital, no diagnosis was settled and the pain persisted. At our ED after a thorough history, physical examination and
diagnostic test no abnormality was found. Finally Abdominal cutaneous nerve entrapment syndrome (ACNES) was
considered and a mixture of 1 ml 2% lidocaine with adrenaline and 1 ml dexamethasone (4 mg) was infiltrated into
the fascial plane in a fanning fashion into the most tender area using a modified technique and the patient reported
significant improvement in pain.
Conclusion Abdominal cutaneous nerve entrapment syndrome (ACNES) is a cause of abdominal pain in pregnancy
that is often overlooked. The objective of this study is to describe a rare case of ACNES in a 26-year-old primigravida
woman who presented to a low-resource emergency department to assist patient management.
Keywords ACNES, Neuropathic pain, Pregnancy
Creator
Melaku Tsediew Berhanu1
, Molla Asnake Kebede2*, Adamu Tigabu Tessfaw3
, Alemayehu Beharu Tekle1
,
Anteneh Messele Birhanu1
and Meron Teka Deresa4
, Molla Asnake Kebede2*, Adamu Tigabu Tessfaw3
, Alemayehu Beharu Tekle1
,
Anteneh Messele Birhanu1
and Meron Teka Deresa4
Source
https://doi.org/10.1186/s12245-024-00720-3
Date
2024
Contributor
Peri Irawan
Format
pdf
Language
english
Type
text
Files
Collection
Citation
Melaku Tsediew Berhanu1
, Molla Asnake Kebede2*, Adamu Tigabu Tessfaw3
, Alemayehu Beharu Tekle1
,
Anteneh Messele Birhanu1
and Meron Teka Deresa4, “A 26 years old primigravida woman presented with abdominal cutaneous entrapment syndrome: a case report,” Repository Horizon University Indonesia, accessed April 25, 2026, https://repository.horizon.ac.id/items/show/12445.