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Inicio Revista Española de Anestesiología y Reanimación (English Edition) Pulsed radiofrequency in a paediatric patient with disabling ACNES
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Vol. 70. Issue 7.
Pages 395-398 (August - September 2023)
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Vol. 70. Issue 7.
Pages 395-398 (August - September 2023)
Case report
Pulsed radiofrequency in a paediatric patient with disabling ACNES
Técnica de radiofrecuencia pulsada en síndrome de ACNES invalidante en una paciente pediátrica
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2
A. Server
Corresponding author
anna.server@vallhebron.cat

Corresponding author.
, V. Sánchez, Á. Mesas, J. Medel
Servicio de Anestesiología, Hospital Universitari Vall d’Hebron, Barcelona, Spain
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Abstract

Chronic abdominal pain is a highly prevalent entity in the paediatric population and represents a diagnostic challenge for professionals. It is frequently underdiagnosed, and must be treated by a multidisciplinary team after a detailed clinical evaluation has been performed to rule out other pathologies. Anterior cutaneous nerve entrapment syndrome (ACNES) occurs when the anterior cutaneous abdominal nerves become pinched or trapped, causing intense, unilateral, circumscribed abdominal pain. Patients often present a positive Pinch test or Carnett’s sign. A stepwise therapeutic approach should be used, reserving the most invasive techniques for patients with refractory ACNES. Among the many different treatments available, local anaesthesia infiltration has shown a high success rate, and surgery should only be performed in the most refractory cases. We report the case of an 11-year old girl with a 6-month history of ACNES that severely affected her quality of life, who responded well to pulsed radiofrequency ablation.

Keywords:
ACNES
Abdominal wall pain
Carnett
Resumen

El dolor abdominal crónico es una entidad muy prevalente en la población pediátrica y supone todo un reto diagnóstico para los profesionales, siendo frecuentemente infradiagnosticada. Requiere un abordaje multidisciplinar y una minuciosa evaluación clínica para descartar otras patologías. El ACNES consiste en un atrapamiento de los nervios cutáneos anteriores de los nervios intercostales y origina un dolor abdominal intenso, unilateral, circunscrito y frecuentemente presenta un Pinch test y un Test de Carnett positivos. El planteamiento terapéutico debería contemplarse desde un enfoque gradual, reservando las técnicas más invasivas para los pacientes con ACNES refractario. Entre los múltiples tratamientos posibles, las infiltraciones locales presentan una alta tasa de éxito, reservando las técnicas quirúrgicas para los casos refractarios. Presentamos el caso clínico de una niña de 11 años, con ACNES de 6 meses de evolución con grave afectación de su calidad de vida y con respuesta favorable a la técnica de radiofrecuencia pulsada.

Palabras clave:
ACNES
Dolor de pared abdominal
Carnett

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