Misdiagnosis of anterior cutaneous nerve entrapment syndrome as a somatization disorder

Abstract

Introduction

Anterior cutaneous nerve entrapment syndrome (ACNES) is a frequently overlooked disease, causing chronic abdominal wall pain due to entrapment of an anterior cutaneous branch of one or more thoracic intercostal nerves. It is often misdiagnosed as a psychiatric condition, particularly under the heading of a somatization disorder.

Objectives

We describe the case of a patient who developed depressive symptoms after months of suffering from chronic abdominal wall pain.

Aims

To report a case-study, describing ACNES as a cause of persistent depressive symptoms.

Methods

A case-study is presented and discussed, followed by a literature review.

Results

A 35-year-female was referred to a psychiatrist for her depressive symptoms and persistent cutaneous abdominal pain for months. There she was diagnosed with a depression and possible somatization disorder and she received psychotherapy. Through Internet search, the patient found ACNES as a possible cause for her persistent abdominal pain. Since administration of anesthetic agents only shortly relieved her symptoms, a surgeon decided to remove the nerve end twigs. After surgery, her somatic problems and depressive mood disappeared.

Conclusion

The awareness of ACNES is still very limited in medicine. This may lead to incorrect diagnoses, including psychiatric disorders such as somatization disorder.

Disclosure of interest

The authors have not supplied their declaration of competing interest.