Kano Yasuhiro, Komagamine Junpei, Murata Kengo
Department of Emergency and General Medicine Tokyo Metropolitan Tama Medical Center Tokyo Japan.
Department of Emergency and Critical Care Medicine NHO Tokyo Medical Center Tokyo Japan.
J Gen Fam Med. 2024 Jul 3;25(6):317-323. doi: 10.1002/jgf2.715. eCollection 2024 Nov.
Anterior cutaneous nerve entrapment syndrome (ACNES) is the most common cause of abdominal wall pain. This study aimed to clarify the proportion of ACNES cases among those of abdominal pain and the clinical characteristics and prognosis of the disease in an emergency department (ED) of a Japanese general hospital.
The medical records of patients from January 2014 to December 2023 were reviewed, and patients aged 15 years or older with abdominal pain with positivity for Carnett's sign, a good response to trigger point injection (TPI), and an ACNES diagnosis were included. The proportion of ACNES cases among the complaints related to abdominal pain in the ED between 2020 and 2023 was then determined. The recurrence rate was also determined using data from the medical records and telephone follow-ups.
Twenty-one patients were included. Their median age was 50 years (range: 16-83 years), 13 (62%) were female, and 11 (52%) had acute-onset pain. Follow-up data were available for 11 patients (52%), seven (64%) of whom had recurrent pain for a median period of 1 week after the index visit. The proportion of ACNES cases among those of abdominal pain was 0.11%.
ACNES might be uncommon among patients with abdominal pain in the ED setting although underdiagnosis of this condition might have led to an underestimation of the proportion of cases. Moreover, given the high recurrence rate of abdominal pain associated with ACNES, following up these patients is very important.
前皮神经卡压综合征(ACNES)是腹壁疼痛最常见的原因。本研究旨在明确日本一家综合医院急诊科中,ACNES病例在腹痛患者中的占比以及该疾病的临床特征和预后。
回顾了2014年1月至2023年12月期间患者的病历,纳入年龄在15岁及以上、有腹痛症状且卡内特征阳性、触发点注射(TPI)反应良好且诊断为ACNES的患者。然后确定2020年至2023年急诊科与腹痛相关主诉中ACNES病例的占比。还利用病历数据和电话随访确定复发率。
纳入21例患者。他们的中位年龄为50岁(范围:16 - 83岁),13例(62%)为女性,11例(52%)为急性起病疼痛。11例患者(52%)有随访数据,其中7例(64%)在首次就诊后中位1周出现复发性疼痛。ACNES病例在腹痛患者中的占比为0.11%。
在急诊科腹痛患者中,ACNES可能并不常见,尽管该疾病的漏诊可能导致病例占比被低估。此外,鉴于与ACNES相关的腹痛复发率较高,对这些患者进行随访非常重要。