Chronic Abdominal Wall Pain Associated with Abdominal Cutaneous Nerve Entrapment Syndrome (ACNES, Carnet?s Sign)

 

Features of ACNES:

(1) The pain is sharp and stabbing.

(2) The pain may be localized to the abdominal wall.

(3) The pain increases with the use of abdominal muscles (Carnett’s sign).

(4) The pain is relieved by instillation of a local anesthetic (such as lidocaine).

(5) Other causes of abdominal pain have been excluded.

 

Some patients with ACNES will be misdiagnosed as having functional pain, or will undergo expensive workups. A few patients will have both ACNES and functional pain.

 

Differential diagnosis of abdominal wall pain:

(1) ACNES

(2) painful lipoma

(3) abdominal wall herniation

(4) painful scar

(5) disorder of muscle in the abdominal wall