Has anyone been diagnosed with Abdominal Wall Pain

Posted by rufus444 @smiles444, Dec 15, 2017

Starting on May 1, 2017, I began having abdominal pain that wraps around to my left back. The first time it happened, I went to the emergency room because I thought I might have an apendicitis. The hospital did a CT scan of my abdomen, everything looked okay. I went to the emergency room several times over the summer with excruciating abdominal and back pain. I had a hida scan done, a colonoscopy and an endoscopy and CT and ultrasound scans of my abdomen. Everything looked normal. In September of this year, a doctor at Mayo felt the area on my abdomen and did a Carnett's test. He suggested it could be abdominal wall pain. I have had two steroid injections and I am still having pain in the same area. Has anyone out there had this type of diagnosis and still having pain?

Interested in more discussions like this? Go to the Chronic Pain Support Group.

@erikas

@rt061069 It sounds like you are seeking appropriate medical care. Despite this you still have been unable to reduce your pain. You have an upcoming appointment 12/7 with GI. Yes, Mayo Clinic is running its clinics despite COVID-19 and as I understand, they are hoping to continue seeing patients. I hope you are able to find answers soon and reduce your pain.

I'm not a provider. I'm not sure what this means, "The pelvis, bladder wall thickness is slightly prominent but this is stable likely muscular hyperplasia accentuated by incomplete distention. No obturator adenopathy. Anterior end plate spurring. left femoral neck spurring possibly the sequela of repetitive impingement."

Would you please explain?

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@erikas just if anyone who is part of this chain or topic rings any bells, those were changes from my current CT to one 18 months ago.

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@rt061069

@erikas just if anyone who is part of this chain or topic rings any bells, those were changes from my current CT to one 18 months ago.

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I'm sorry, I'm completely confused.. is this a reply to the person asking about the abdominal wall pain?....

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@elle1233 I started posting this year, I have non stop ab wall pain from pelvis to xiphoid, it started in spring of 2018 and has gotten worse each month. Tests dont come up with anything and pain meds dont work for me. Just wondering what kind of help I will get on 12/7 with Mayo with covid exploding for the clinic and St Marys. It doesnt seem to be GI related per scans and a colonoscopy. I am very desperate now in my condition of pain, starting zoon today with a thearpist and have a zoom with a pain mgt doctor I have used before on Tuesday. She is now mentioning radio frequency ablation but we are still not sure the exact troubled nerves/triggers. They took so long at this hospital pain clinic that I started looking for a new one pain doctor a month ago, he tried some trigger point injections above my naval area that only numbed some for 10 hours. No doctor in my city of St Louis has ever mentioned ACNE.

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@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.

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@erikas

@rt061069 It sounds like you are seeking appropriate medical care. Despite this you still have been unable to reduce your pain. You have an upcoming appointment 12/7 with GI. Yes, Mayo Clinic is running its clinics despite COVID-19 and as I understand, they are hoping to continue seeing patients. I hope you are able to find answers soon and reduce your pain.

I'm not a provider. I'm not sure what this means, "The pelvis, bladder wall thickness is slightly prominent but this is stable likely muscular hyperplasia accentuated by incomplete distention. No obturator adenopathy. Anterior end plate spurring. left femoral neck spurring possibly the sequela of repetitive impingement."

Would you please explain?

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@erikas: Quote from a physician site on AWPS: "Textbooks of surgery, medicine, gastro-enterology, neurology, and gynecology all fail to mention ACNES as an important representative of the group of Abdominal Wall Pain Syndrome." Do you begin to see what an impossible burden this puts on patients trying to find help?

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@hopeful33250

Hello All:

I thought you would find this video interesting. It deals with chronic abdominal wall pain. After you watch the video please share your thoughts.

Mayo Clinic gastroenterologist, Dr. Amy Oxentenko talks about an article published in Mayo Clinic Proceedings, detailing the complexities of chronic abdominal wall pain (CAWP) – a condition that seems elusive to any workup.

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Dr. Oxentenko: "Textbooks of surgery, medicine, gastro-enterology, neurology, and gynecology all fail to mention ACNES as an important representative of the group of Abdominal Wall Pain Syndrome." https://link.springer.com/article/10.1007/s10029-017-1710-z
Do you begin to see what an impossible burden this puts on patients trying to find help?

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@rt061069

@elle1233 I started posting this year, I have non stop ab wall pain from pelvis to xiphoid, it started in spring of 2018 and has gotten worse each month. Tests dont come up with anything and pain meds dont work for me. Just wondering what kind of help I will get on 12/7 with Mayo with covid exploding for the clinic and St Marys. It doesnt seem to be GI related per scans and a colonoscopy. I am very desperate now in my condition of pain, starting zoon today with a thearpist and have a zoom with a pain mgt doctor I have used before on Tuesday. She is now mentioning radio frequency ablation but we are still not sure the exact troubled nerves/triggers. They took so long at this hospital pain clinic that I started looking for a new one pain doctor a month ago, he tried some trigger point injections above my naval area that only numbed some for 10 hours. No doctor in my city of St Louis has ever mentioned ACNE.

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@rt061069
To clear up any confusion, ACNES is an acronym that stands for "anterior cutaneous nerve entrapment syndrome". It is completely different from acne, the skin disease, which is not an acronym. Best, Hank

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@rritam

@erikas: Quote from a physician site on AWPS: "Textbooks of surgery, medicine, gastro-enterology, neurology, and gynecology all fail to mention ACNES as an important representative of the group of Abdominal Wall Pain Syndrome." Do you begin to see what an impossible burden this puts on patients trying to find help?

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@rritam, you're correct. Abdominal wall pain is a common and often underrecognized cause of chronic abdominal pain. Like any underrecognized symptom or condition, whether common or rare, there is an unwelcome burden beyond illness placed on the patient. Often it is the patient who contributes knowledge of the pain, research from internet or library sources, and anecdotal evidence from forums like this one to their health care team to help investigate and diagnose abdominal wall conditions such as ACNES (anterior cutaneous nerve entrapment syndrome).

In addition to the Dutch paper you cite and work by the American Academy of Family Physicians (https://www.aafp.org/afp/2001/0801/p431.html), Mayo Clinic provides continuing medical education about ACNES for internal medicine physicians and other clinicians who wish to advance their current knowledge of clinical medicine and who wish to stay abreast of advances in medical research. See Mayo Clinic Proceedings here: https://www.mayoclinicproceedings.org/article/S0025-6196(18)30671-2/fulltext

Patients working their doctors today pave the way for better knowledge and understanding for patients in the future. @rritam, what do you advise fellow patients when they suspect ACNES as a possible diagnosis?

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@colleenyoung How do you expect a patient like me suffering for years, to help? Don't you think if I had any good ideas I would have shared them a long time ago? How nice of Mayo to educate its own physicians and neglect the larger issue of the 24 physicians in Washington who brushed me off (not including the 5 who refused to see me at all)! ALL DISCIPLINES need the information, including pain specialists, psychotherapists, psychiatry, hospitals and ERs, Walk-in Clinics, Physical Therapy, Urgent Cares in addition to all the textbook fail specialties listed in my post.. I've communicated to Mayo and MedScape (to name two) with no response from either, even MAYO physicians including your Dr. Sweetser? I'm to help educate patients who been betrayed by so many physicians for so long? Why should they believe me--and I don't blame them!--after YOUR clinics apparently continue to fail them?

Why have I continued to post? After hundreds of dollars' worth of downloaded physician literature, research, findings, treatments, I HAVE ALREADY TRIED. With printouts from your Feb 2019 Proceedings, trigger point injections,TAP blocks that physicians ignored. You know how I finally received care?
I convinced a physician to perform resection of branches of T7, T8, and T9 after I threatened to kill myself. I believe no patient should have to do that. That is why I continue to post...and not because Mayo sent me some BS 'bronze award'!

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@colleenyoung: Mayo gastroenterology sent me a form letter 2/28/2019 after MY dx of A.C.N.E.S. "We do not believe that a visit to MAYO clinic would add to the care you have already received." I asked for information, NOT AN APPOINTMENT. I was refused both. The "care I already received"? I had received NO CARE AT ALL.

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