Successful treatment of abdominal cutaneous entrapment syndrome using ultrasound guided injection

Abstract

There are various origins for chronic abdominal pain. About 10-30% of patients with chronic abdominal pain have abdominal wall pain. Unfortunately, abdominal wall pain is not thought to be the first origin of chronic abdominal pain; therefore, patients usually undergo extensive examinations, including diagnostic laparoscopic surgery. Entrapment of abdominal cutaneous nerves at the muscular foramen of the rectus abdominis is a rare cause of abdominal wall pain. If abdominal wall pain is considered in earlier stage of chronic abdominal pain, unnecessary invasive procedures are not required and patients will reach symptom free condition as soon as the diagnosis is made. Here, we report a case of successful treatment of a patient with abdominal cutaneous nerve entrapment syndrome by ultrasound guided injection therapy.

Keywords: abdominal pain; abdominal wall; nerve compression syndromes; ultrasonography.

Fig. 1

Placement of ultrasound transducer and needle over the lateral end of the rectus abdominis muscle.

Fig. 2

Ultrasound guided block of the abdominal cuateneous nerve, using the transverse scan of rectus abdominis muscle. Under the ultrasound guidance (12-5 Hz linear probe), the needle was advanced with the short axis in plane technique to reach the target area. 1: Rectus abdominis, 2: Linea semilunaris, 3: Internal oblique, 4: Transversus abdominis, ^*: Abdominal cutaneous nerve, White arrows are marked tracing needle trajectory.