@rt061069, the only complexity in diagnosing A.C.N.E.S. is huge ignorance of the problem. TAP block can help convince skeptical physicians. Carnett's test is diagnostic in patients with otherwise negative abd findings, and anesthetic injection into the pain trigger area(s) is a strong indicator of A.C.N.E.S if your pain's relieved, EVEN IF ONLY FOR A SHORT TIME. I went thru 24 physicians (all of whom had never heard of A.C.N.E.S.). Gastroenterology is a fail if they won't do Carnett's, because they'll do all their expensive testing and then brush you off. My surgeon had no problem locating the offending nerve branches and resecting them. If your physician isn't performing Carnett's, she's not isolating the pain triggers. If she doesn't isolate the pain triggers for you.... good luck. I would've gone to Oliver Boelens MD if it weren't for COVID. He and his clinic (Netherlands) are the experts.