%0 Journal Article %A Tijmen van Assen %A Jenneke W. A. J. de Jager-Kievit %A Marc R. Scheltinga %A Rudi M. H. Roumen %T Chronic Abdominal Wall Pain Misdiagnosed as Functional Abdominal Pain %D 2013 %R 10.3122/jabfm.2013.06.130115 %J The Journal of the American Board of Family Medicine %P 738-744 %V 26 %N 6 %X Introduction: The abdominal wall is often neglected as a cause of chronic abdominal pain. The aim of this study was to identify chronic abdominal wall pain syndromes, such as anterior cutaneous nerve entrapment syndrome (ACNES), in a patient population diagnosed with functional abdominal pain, including irritable bowel syndrome, using a validated 18-item questionnaire as an identification tool. Methods: In this cross-sectional analysis, 4 Dutch primary care practices employing physicians who were unaware of the existence of ACNES were selected. A total of 535 patients ≥18 years old who were registered with a functional abdominal pain diagnosis were approached when they were symptomatic to complete the questionnaire (maximum 18 points). Responders who scored at least the 10-point cutoff value (sensitivity, 0.94; specificity, 0.92) underwent a diagnostic evaluation to establish their final diagnosis. The main outcome was the presence and prevalence of ACNES in a group of symptomatic patients diagnosed with functional abdominal pain. Results: Of 535 patients, 304 (57%) responded; 167 subjects (31%) recently reporting symptoms completed the questionnaire. Of 23 patients who scored above the 10-point cutoff value, 18 were available for a diagnostic evaluation. In half of these subjects (n = 9) functional abdominal pain (including IBS) was confirmed. However, the other 9 patients were suffering from abdominal wall pain syndrome, 6 of whom were diagnosed with ACNES (3.6% prevalence rate of symptomatic subjects; 95% confidence interval, 1.7–7.6), whereas the remaining 3 harbored a painful lipoma, an abdominal herniation, and a painful scar. Conclusion: A clinically relevant portion of patients previously diagnosed with functional abdominal pain syndrome in a primary care environment suffers from an abdominal wall pain syndrome such as ACNES. %U https://www.jabfm.org/content/jabfp/26/6/738.full.pdf