Research Output
Protracted diagnosis of ACNES: a costly exercise
  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.

  • Type:


  • Date:

    01 September 2018

  • Publication Status:


  • Publisher

    Oxford University Press (OUP)

  • DOI:


  • Library of Congress:

    RD Surgery

  • Dewey Decimal Classification:

    617 Surgery & related medical specialties

  • Funders:

    NHS Health Scotland


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.



Cost effectiveness, diagnostic services, hernia, anterior cutaneous nerve entrapment syndrome (ACNES),

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    Protracted diagnosis of ACNES: a costly exercise


    Published by Oxford University Press and JSCR Publishing Ltd. All rights reserved. © The Author(s) 2018.
    This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (, which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
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