Characteristics of children presenting to the emergency department with anterior cutaneous nerve entrapment syndrome.

BACKGROUND

Anterior cutaneous nerve entrapment syndrome (ACNES) causes acute or chronic abdominal pain. Hitherto, there are no reports of patients presenting with pediatric ACNES in an emergency department (ED). The present study aimed to clarify the clinical characteristics and treatment outcomes of children with ACNES diagnosed in an ED.

METHODS

The present, retrospective case series study analyzed children with ACNES diagnosed at the ED of Tokyo Metropolitan Children's Medical Center between March 2010 and December 2023. Data on the patients were collected from their electronic records, and the presence of recurrences was confirmed by reviewing the electronic records or contacting the patient directly by telephone.

RESULTS

Sixteen patients with ACNES (median age: 11 years; range: 9-14 years; females: 50%) were extracted, in all of whom the condition had been diagnosed after 2018. The duration from onset to diagnosis was a median of 3 days (range: 0-46 days). The ACNES-related abdominal pain was characterized by right-sidedness, sharpness, and exacerbation with movement. Pseudovisceral symptoms occurred in 63% of the patients, most of whom had typical physical findings, such as Carnett's sign. Local anesthetic injections were administered in 31% of the patients and were effective in all of these. ACNES recurred in 60% of the patients who had received an injection.

CONCLUSIONS

Anterior cutaneous nerve entrapment syndrome was diagnosed earlier in children presenting to the ED than in previously reported patients with the chronic form of this condition. Pediatricians and emergency physicians should consider ACNES in patients with severe abdominal pain and administer treatment promptly.