{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T15:35:09Z","timestamp":1772724909874,"version":"3.50.1"},"reference-count":18,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,2,12]]},"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:p>Anterior cutaneous nerve entrapment syndrome (ACNES) is an under-recognised cause of chronic abdominal or chest wall pain in the era of increased reliance on diagnostic imaging and laboratory studies. We present the case of a man in his mid-60s who was hospitalised eight times over a 2-year period for unexplained abdominal pain despite extensive non-diagnostic workups. Careful re-examination, focusing on physical examination, demonstrated a positive Carnett\u2019s sign, leading to the diagnosis of ACNES. Ultrasound-guided trigger point injection with corticosteroid and local anaesthetic led to immediate symptom relief, confirming the diagnosis. This case highlights the diagnostic value of the physical exam and the need to consider ACNES in patients with persistent abdominal pain and normal imaging and laboratory studies, as early diagnosis can reduce symptom burden, prevent unnecessary testing and improve patient outcomes.<\/jats:p>","DOI":"10.1136\/bcr-2025-270977","type":"journal-article","created":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T14:35:18Z","timestamp":1772721318000},"page":"e270977","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Anterior cutaneous nerve entrapment syndrome (ACNES) disguised as recurrent abdominal pain: a diagnostic challenge with a simple solution"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5661-0359","authenticated-orcid":false,"given":"Tom\u00e1s","family":"Correa Gaviria","sequence":"first","affiliation":[{"name":"Internal Medicine, Yale New Haven Hospital, New Haven, Connecticut, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ysabel","family":"Ilagan-Ying","sequence":"additional","affiliation":[{"name":"Section of Digestive Diseases, Department of Internal Medicine, Yale School of Medicine, Yale New Haven Hospital, New Haven, Connecticut, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2026,3,5]]},"reference":[{"key":"2026030506350817000_19.3.e270977.1","doi-asserted-by":"crossref","first-page":"213","DOI":"10.2169\/internalmedicine.50.4179","article-title":"Diagnostic usefulness of Carnett\u2019s test in psychogenic abdominal pain","volume":"50","author":"Takada","year":"2011","journal-title":"Intern Med"},{"key":"2026030506350817000_19.3.e270977.2","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1016\/j.mayocp.2018.09.018","article-title":"Chronic Abdominal Wall Pain: A Common Yet Overlooked Etiology of Chronic Abdominal Pain","volume":"94","author":"Kamboj","year":"2019","journal-title":"Mayo Clin Proc"},{"key":"2026030506350817000_19.3.e270977.3","doi-asserted-by":"crossref","DOI":"10.1186\/s13104-017-2816-1","article-title":"Anterior cutaneous nerve entrapment syndrome with pain present only during Carnett\u2019s sign testing: a case report","volume":"10","author":"Tanizaki","year":"2017","journal-title":"BMC Res Notes"},{"key":"2026030506350817000_19.3.e270977.4","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1016\/j.surg.2018.08.011","article-title":"Factors predicting outcome after anterior neurectomy in patients with chronic abdominal pain due to anterior cutaneous nerve entrapment syndrome (ACNES)","volume":"165","author":"Mol","year":"2019","journal-title":"Surgery"},{"key":"2026030506350817000_19.3.e270977.5","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2012-002257","article-title":"Junior doctor skill in the art of physical examination: a retrospective study of the medical admission note over four decades","volume":"3","author":"Oliver","year":"2013","journal-title":"BMJ Open"},{"key":"2026030506350817000_19.3.e270977.6","doi-asserted-by":"crossref","DOI":"10.1093\/jscr\/rjy230","article-title":"Protracted diagnosis of ACNES: a costly exercise","volume":"2018","author":"Dancer","year":"2018","journal-title":"J Surg Case Rep"},{"key":"2026030506350817000_19.3.e270977.7","doi-asserted-by":"publisher","DOI":"10.1016\/S1542-3565(04)00124-7"},{"key":"2026030506350817000_19.3.e270977.8","doi-asserted-by":"crossref","DOI":"10.1016\/S0016-5085(08)83167-8","article-title":"Abdominal wall syndrome: A costly diagnosis of exclusion","volume":"120","author":"Thompson","year":"2001","journal-title":"Gastroenterology"},{"key":"2026030506350817000_19.3.e270977.9","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1097\/SLA.0000000000003224","article-title":"Characteristics of 1116 Consecutive Patients Diagnosed With Anterior Cutaneous Nerve Entrapment Syndrome (ACNES)","volume":"273","author":"Mol","year":"2021","journal-title":"Ann Surg"},{"key":"2026030506350817000_19.3.e270977.10","unstructured":"Meyer GW . Anterior cutaneous nerve entrapment syndrome. In: Connor RF , ed. UpToDate. Waltham (MA): Wolters Kluwer, 2025."},{"key":"2026030506350817000_19.3.e270977.11","doi-asserted-by":"crossref","unstructured":"Yagi S , Taoka M , Inaba K , et al . Anterior Cutaneous Nerve Entrapment Syndrome Triggered by Thoracic Compression Fracture and Weight Loss. 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