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Acnes
(abdominal costal nerve
entrapment syndrome)
Acnes is a syndrome with pain complaints at a specific place in the abdominal wall. It is often poorly recognized because it is not widely known. A lot of diagnostic procedures has often been performed already.
The cause of the pain is an irritation of a sensory nerve at the place where the nerve passes through the fascia of the rectus abdominal muscle. The pain can be relieved by an injection at the specific painspot. Sometimes this injection can have a permanent positive effect, but mostly it is temporarily. In that case an operation can be performed to cut the nerve and achieve a painless situation. It takes about 4- weeks to recover from the pain of the wound but then the original pain will be gone.
At the operation a transverse incision is made at the point of the pain. The fatty tissue is cut and the fascia is seen. (1-4)
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Then the nerve and the accompanying vessels are looked for. After coagulation the nerve is cut below the level of the fascia. Sometimes there are even more nerves that are being treated in the same way. Then the fascia is closed as well as the subcutaneous layer and the skin. (5-9)
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Recently an article was published on this rather unknown syndrome (Ned Tijdschr Geneeskd. 2006 2 september;150(35)).