Children with suspected anterior cutaneous nerve entrapment syndrome (ACNES), it’s not all the abdominal wall
Year: 2026
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Anterior cutaneous nerve entrapment syndrome (ACNES) is a chronic pain syndrome that also occurs in children. The European Pain Federation EFIC recommends the application of the biopsychosocial model of pain. In children with suspected ACNES, the use of this model in diagnosis and treatment appears underused. Most publications focus on invasive interventions. These are potentially harming patients due to this one-dimensional approach. We aimed to assess the use of the biopsychosocial model during the diagnosis and treatment of children with chronic abdominal pain and suspected ACNES before referral to a tertiary paediatric pain centre (PPC) and diagnosis and treatment outcomes in the PPC using the biopsychosocial model. DESIGN: Single-centre retrospective cohort study of patients referred to a tertiary PPC with (suspected) diagnosis of ACNES between November 2017 and March 2024. PRIMARY OUTCOME: Use of the biopsychosocial model and treatments performed before referral to the PPC. SECONDARY OUTCOMES: Confirmation of the diagnosis of ACNES on assessment and results of therapeutic interventions performed in the PPC. RESULTS: 31 patients were included. In less than 25% of the patients, the biopsychosocial model was used before referral. The treatments performed were diverse. At the PCC, in none of the cases could the diagnosis of ACNES be solidly confirmed. After treatment using the biopsychosocial model in the PPC, 20 patients (64.5%) reported less or absence of pain. CONCLUSION: Failure to use the biopsychosocial model in the treatment of suspected ACNES in children might lead to unnecessary invasive interventions with a risk of persistence of pain while the pain-maintaining factors are inadequately addressed. Therefore, a diagnostic-treatment algorithm is proposed.
Source: BMJ Paediatrics Open
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7127992849