Session Information
Session Title: AA 2021 Virtual Posters - Pain and Spine Medicine
Session Time: None. Available on demand.
Disclosures: Jason Lam, DO: No financial relationships or conflicts of interest
Case Diagnosis: A 70 year old male with a past surgical history of laparoscopic cholecystectomy presented with anterior cutaneous nerve entrapment syndrome (ACNES) from his laparoscopic trocar site.
Case Description: The patient complained of localized anterior abdominal pain months after his cholecystectomy. He had lab work and abdominal imaging done by his primary care physician which did not show anything significant. The patient received 2 trials of trigger point injections (TPI) to his abdominal wall at the trocar site with good temporary relief for about 2 days. He was diagnosed with ACNES likely from the surgical scar tissues entrapping the nerves. The patient then underwent pulsed radiofrequency (PRF) directed at the trocar site guided under fluoroscopy. PRF was performed at 42° C for 120 seconds.
Discussion: In the current medical landscape, the main treatment approach of ACNES is for trial of TPI and to proceed directly to neurectomy for cases that are refractory to conservative treatment. Although limited, there are studies done supporting the use of PRF in ACNES refractory to conservative measures.
Setting: Private practice outpatient settingAssessment/
Results: At 6 weeks post procedure follow up, the patient endorsed significant sustained improvement in his abdominal pain. He now was able to get out of bed and perform his daily activities without much pain.
Conclusion: Our case report supports the use of PRF in ACNES refractory to TPI. This is not to suggest that PRF is superior to neurectomy but that this minimally invasive technique should be incorporated in the treatment protocol for ACNES prior to proceeding with neurectomy especially since it can potentially prevent the need for surgical treatments in some patients.
Level of Evidence: Level V
To cite this abstract in AMA style:
Lam J, Chen CK, Chen K, Quraishi W. Pulsed Radiofrequency for the Treatment of Anterior Cutaneous Nerve Entrapment Syndrome: A Case Report [abstract]. PM R. 2021; 13(S1)(suppl 1). https://pmrjabstracts.org/abstract/pulsed-radiofrequency-for-the-treatment-of-anterior-cutaneous-nerve-entrapment-syndrome-a-case-report/. Accessed May 12, 2025.« Back to AAPM&R Annual Assembly 2021
PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/pulsed-radiofrequency-for-the-treatment-of-anterior-cutaneous-nerve-entrapment-syndrome-a-case-report/