Department of Family Medicine, East Carolina University Brody School of Medicine, Greenville, North Carolina, USA
Department of Family Medicine, East Carolina University Brody School of Medicine, Greenville, North Carolina, USA.
BMJ Case Rep. 2020 Sep 7;13(9):e234619. doi: 10.1136/bcr-2020-234619.
A 31-year-old G2P1001 woman at a 30-week gestation presented with a recurrence of pinpoint right upper abdominal wall pain. She had been diagnosed with an anterior cutaneous nerve entrapment syndrome (ACNES) during her first pregnancy at a similar gestational age, a well-described but frequently under-recognised entity. The pain during that pregnancy resolved immediately and completely following normal spontaneous vaginal delivery, however,the pain was worse with this presenting pregnancy. She underwent an ultrasound-guided rectus sheath nerve block at 30 weeks with complete and immediate relief for the remainder of the pregnancy. During a third pregnancy, she suffered another recurrence; however, it was less severe than in the prior pregnancies and was managed conservatively. It again resolved completely and immediately with normal spontaneous vaginal delivery. The pattern of ACNES recurrence during the same gestational age in all three pregnancies with total relief following deliveries demonstrates a clear primary mechanical aetiology.
一位 31 岁，G2P1001 的女性，妊娠 30 周，诉右上腹出现针尖样疼痛复发。她在第一次妊娠时，于类似孕周被诊断为前皮神经卡压综合征（ACNES），这是一种描述明确但经常被低估的疾病。那次妊娠时，疼痛在正常自发性阴道分娩后立即完全缓解，但本次妊娠时疼痛更严重。她在 30 周时接受了超声引导下腹直肌鞘神经阻滞，整个妊娠过程中疼痛完全缓解。在第三次妊娠时，她再次复发，但疼痛程度比前两次妊娠轻，保守治疗后缓解。再次通过正常的自发性阴道分娩完全且立即缓解。在所有三次妊娠中，ACNES 在同一孕周复发，分娩后完全缓解，这表明其具有明确的原发性机械病因。
