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Kiteboarding Induced Abdominal Wall Pain: Intercostal Neuroma versus Anterior Cutaneous Nerve Entrapment (ACNES)

Abdominal wall pain can be challenging to diagnose and treat, as many etiologies can have similar presentations. Anterior cutaneous nerve entrapment syndrome has been reported to be a significant cause of AWP. Here, we report the case of a patient who was initially diagnosed with anterior cutaneous...

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Autores principales: Stoehr, Jenna Rose, Chappell, Ava G., Dumanian, Gregory A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7963503/
https://www.ncbi.nlm.nih.gov/pubmed/33747695
http://dx.doi.org/10.1097/GOX.0000000000003487
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author Stoehr, Jenna Rose
Chappell, Ava G.
Dumanian, Gregory A.
author_facet Stoehr, Jenna Rose
Chappell, Ava G.
Dumanian, Gregory A.
author_sort Stoehr, Jenna Rose
collection PubMed
description Abdominal wall pain can be challenging to diagnose and treat, as many etiologies can have similar presentations. Anterior cutaneous nerve entrapment syndrome has been reported to be a significant cause of AWP. Here, we report the case of a patient who was initially diagnosed with anterior cutaneous nerve entrapment syndrome and ultimately found to have intercostal neuromas-in-continuity. The patient was a healthy 36-year-old man who presented with debilitating, chronic abdominal wall pain. The pain began after a time period when the patient was regularly kiteboarding, and it impacted the ability to exercise and perform activities of daily living. The patient had undergone extensive testing and attempted many treatments, including medication, nerve blocks, and anterior cutaneous nerve entrapment syndrome surgery. Examination was significant for 2 near-symmetric areas that were persistently tender to palpation in the subcostal abdomen. The patient underwent excision and reconstruction with two 2-cm segments of processed nerve allograft. At 1-year follow-up, the patient reported complete alleviation of the pain, discontinuation of pain medication, and a return to all normal activities. While managing patients with abdominal wall pain, physicians must consider neuroma in their differential diagnoses and be aware of its treatment options, as the patient underwent a substantial delay in treatment. Kiteboarding is a unique mechanism of peripheral nerve injury that has not been previously reported in the literature. This report demonstrates the efficacy of processed nerve allograft in the management of neuromas-in-continuity of the abdominal wall, as well as the importance of being aware of unusual manners of nerve injury.
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spelling pubmed-79635032021-03-18 Kiteboarding Induced Abdominal Wall Pain: Intercostal Neuroma versus Anterior Cutaneous Nerve Entrapment (ACNES) Stoehr, Jenna Rose Chappell, Ava G. Dumanian, Gregory A. Plast Reconstr Surg Glob Open Reconstructive Abdominal wall pain can be challenging to diagnose and treat, as many etiologies can have similar presentations. Anterior cutaneous nerve entrapment syndrome has been reported to be a significant cause of AWP. Here, we report the case of a patient who was initially diagnosed with anterior cutaneous nerve entrapment syndrome and ultimately found to have intercostal neuromas-in-continuity. The patient was a healthy 36-year-old man who presented with debilitating, chronic abdominal wall pain. The pain began after a time period when the patient was regularly kiteboarding, and it impacted the ability to exercise and perform activities of daily living. The patient had undergone extensive testing and attempted many treatments, including medication, nerve blocks, and anterior cutaneous nerve entrapment syndrome surgery. Examination was significant for 2 near-symmetric areas that were persistently tender to palpation in the subcostal abdomen. The patient underwent excision and reconstruction with two 2-cm segments of processed nerve allograft. At 1-year follow-up, the patient reported complete alleviation of the pain, discontinuation of pain medication, and a return to all normal activities. While managing patients with abdominal wall pain, physicians must consider neuroma in their differential diagnoses and be aware of its treatment options, as the patient underwent a substantial delay in treatment. Kiteboarding is a unique mechanism of peripheral nerve injury that has not been previously reported in the literature. This report demonstrates the efficacy of processed nerve allograft in the management of neuromas-in-continuity of the abdominal wall, as well as the importance of being aware of unusual manners of nerve injury. Lippincott Williams & Wilkins 2021-03-15 /pmc/articles/PMC7963503/ /pubmed/33747695 http://dx.doi.org/10.1097/GOX.0000000000003487 Text en Copyright © 2021 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (https://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Reconstructive
Stoehr, Jenna Rose
Chappell, Ava G.
Dumanian, Gregory A.
Kiteboarding Induced Abdominal Wall Pain: Intercostal Neuroma versus Anterior Cutaneous Nerve Entrapment (ACNES)
title Kiteboarding Induced Abdominal Wall Pain: Intercostal Neuroma versus Anterior Cutaneous Nerve Entrapment (ACNES)
title_full Kiteboarding Induced Abdominal Wall Pain: Intercostal Neuroma versus Anterior Cutaneous Nerve Entrapment (ACNES)
title_fullStr Kiteboarding Induced Abdominal Wall Pain: Intercostal Neuroma versus Anterior Cutaneous Nerve Entrapment (ACNES)
title_full_unstemmed Kiteboarding Induced Abdominal Wall Pain: Intercostal Neuroma versus Anterior Cutaneous Nerve Entrapment (ACNES)
title_short Kiteboarding Induced Abdominal Wall Pain: Intercostal Neuroma versus Anterior Cutaneous Nerve Entrapment (ACNES)
title_sort kiteboarding induced abdominal wall pain: intercostal neuroma versus anterior cutaneous nerve entrapment (acnes)
topic Reconstructive
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7963503/
https://www.ncbi.nlm.nih.gov/pubmed/33747695
http://dx.doi.org/10.1097/GOX.0000000000003487
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