Pulsed Radiofrequency Ablation for Anterior Cutaneous Nerve Entrapment Syndrome: A Case Report: PRF For ACNES: A Case Report

Anterior Cutaneous Nerve Entrapment Syndrome (ACNES) is a cause of chronic abdominal pain in which nerves become pathologically entrapped and irritated, leading to pain.  The prevalence of the syndrome is 15 to 30 percent, and many treatment approaches begin with pharmacologic therapy.  If pharmacologic therapy fails, trigger point injections, nerve blocks, and neurectomy are subsequent therapeutic options.  We present the case of a 50-year-old female with chronic abdominal pain and steroid allergy who presented to the pain clinic after failed mainstay therapy including gabapentin, amitriptyline, nortriptyline, duloxetine, NSAID, and acetaminophen.  She was diagnosed with Anterior Cutaneous Nerve Entrapment Syndrome (ACNES).  A primary intervention of Bilateral Transversus Abdominis Plane (TAP) Block with local anesthetic provided 80% pain relief.  Following successful primary intervention, a secondary intervention of Pulsed Radiofrequency Ablation (PRF) provided pain relief for 2 months.