Protracted diagnosis of ACNES: a costly exercise

Dancer, S J; Macpherson, S G; de Beaux, A C

Abstract

This case report summarizes the course of events leading to diagnosis and eventual repair of anterior cutaneous nerve entrapment syndrome (ACNES) in a 58-year-old female. The time period elapsing from initial symptoms to final operative repair was 9 months. The diagnosis was missed by both medical and surgical specialists despite multiple outpatient appointments, investigative procedures and a battery of laboratory tests. The diagnosis of ACNES was first considered when reviewed by a hernia surgeon and subsequently confirmed following open exploration of the anterior abdominal wall. The nerve was released and pain symptoms resolved. Access to the NHS Scotland ISD register permitted an economic analysis of the diagnostic services utilized for this patient and these totalled nearly £11 500. At a time when the NHS is focused on cost effectiveness, this particular sequence of investigations illustrates a protracted and costly diagnostic pathway.

Citation

Dancer, S. J., Macpherson, S. G., & de Beaux, A. C. (2018). Protracted diagnosis of ACNES: a costly exercise. Journal of Surgical Case Reports, 2018(9), 1-3. https://doi.org/10.1093/jscr/rjy230

• Journal Article Type: Other
• Acceptance Date: Aug 16, 2018
• Online Publication Date: Sep 6, 2018
• Publication Date: Sep 1, 2018
• Deposit Date: Nov 14, 2018
• Publicly Available Date: Nov 14, 2018
• Journal: Journal of Surgical Case Reports
• Publisher: Oxford University Press
• Peer Reviewed: Peer Reviewed
• Volume: 2018
• Issue: 9
• Pages: 1-3
• DOI: https://doi.org/10.1093/jscr/rjy230
• Keywords: Cost effectiveness, diagnostic services, hernia, anterior cutaneous nerve entrapment syndrome (ACNES),
• Public URL: http://researchrepository.napier.ac.uk/Output/1306015
• Contract Date: Nov 14, 2018