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<p>Anterior cutaneous nerve entrapment syndrome (ACNES) is a frequently overlooked cause of chronic abdominal wall pain due to its nonspecific symptoms, which often mimic gastrointestinal disorders. It typically results from nerve entrapment near the lateral border of the rectus abdominis. This case describes a 17-year-old female with persistent abdominal pain and vomiting for 3 months, ultimately diagnosed with ACNES. High-resolution ultrasound revealed entrapment of an upper anterior cutaneous nerve, which was treated with ultrasound-guided hydrodissection using a combination of lidocaine, bupivacaine, and betamethasone. The patient experienced immediate relief, and complete resolution was achieved after a second procedure, with sustained improvement at follow-up. This report expands on current literature by demonstrating the successful use of ultrasound-guided hydrodissection in an adolescent patient, with specific fascial findings on imaging and long-term symptom resolution. It underscores the value of targeted, minimally invasive intervention in the diagnosis and treatment of ACNES.</p>

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Anterior cutaneous nerve entrapment syndrome (ACNES) and hydrodissection treatment: case report

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年10月30日

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  • Orsula Staka,
  • Steven Tanguilig,
  • Mahant Malempati,
  • Tasfiqul Chowdhury,
  • Kelli Morrell,
  • Irina Parau,
  • Jacques Courseault

摘要

Anterior cutaneous nerve entrapment syndrome (ACNES) is a frequently overlooked cause of chronic abdominal wall pain due to its nonspecific symptoms, which often mimic gastrointestinal disorders. It typically results from nerve entrapment near the lateral border of the rectus abdominis. This case describes a 17-year-old female with persistent abdominal pain and vomiting for 3 months, ultimately diagnosed with ACNES. High-resolution ultrasound revealed entrapment of an upper anterior cutaneous nerve, which was treated with ultrasound-guided hydrodissection using a combination of lidocaine, bupivacaine, and betamethasone. The patient experienced immediate relief, and complete resolution was achieved after a second procedure, with sustained improvement at follow-up. This report expands on current literature by demonstrating the successful use of ultrasound-guided hydrodissection in an adolescent patient, with specific fascial findings on imaging and long-term symptom resolution. It underscores the value of targeted, minimally invasive intervention in the diagnosis and treatment of ACNES.