Abdominal Cutaneous Nerve Entrapment Syndrome (ACNES)
Abdominal cutaneous nerve entrapment syndrome (ACNES) is not an uncommon condition. When a patient is seen for abdominal pain without other clinically significant symptoms, ACNES should be high on the list of likely diagnoses.
The condition was first described by J P Frank in 1792, who coined the term “peritonitis muscularis.” Abdominal wall pain can often be wrongly attributed to intra-abdominal disorders. This misdirected diagnosis can lead to unnecessary consultation, testing, and even abdominal surgery. All of these can be avoided if the initial examination points to the right diagnosis.
Carnett in the early 20th century, called this syndrome “intercostal neuralgia” and claimed to have seen three patients per week with this diagnosis, including as many as three per day in consultation sessions.