The anterior cutaneous nerves of the abdomen are the medial terminal branches of the thoracic intercostal nerves T7-T12, which pierce the posterior rectus sheath and the rectus abdominis to emerge through the anterior sheath as the anterior cutaneous branches. They supply the anterior abdominal skin in segmental dermatomal bands, with T10 corresponding to the umbilical level and T12 to the suprapubic region.
| Origin | Terminal anterior cutaneous branches of the anterior rami of T7-T12 |
|---|---|
| Course | Run between internal oblique and transversus abdominis, enter the rectus sheath, and pierce rectus abdominis and the anterior sheath a short distance from the midline |
| Sensory |
|
Anterior cutaneous nerve entrapment syndrome (ACNES) is an under-recognised cause of chronic abdominal pain, where the anterior cutaneous nerve is entrapped as it pierces the anterior rectus sheath at the lateral rectus edge. The pain is sharp, lateralised, and reproduced by the Carnett test (pain increases with abdominal wall contraction). Trigger point injection or ultrasound-guided nerve block at the entrapment site is diagnostic and therapeutic. Chronic ACNES is treated by surgical neurotomy. The anterior cutaneous nerves are at risk in paramedian and midline laparotomy closures if sutures are placed too laterally.
Entrapment of T10-T12 anterior cutaneous nerves at the lateral rectus sheath edge produces chronic abdominal wall pain that is superficial, lateralised, and worsened by Carnett test; distinguished from visceral pain by the positive Carnett test and reproduced by pressure at the nerve entry point, managed by injection and if persistent by surgical neurotomy.
This website uses cookies to enhance your experience. Some are essential for site functionality, while others help us analyze and improve your usage experience. Please review your options and make your choice.
If you are under 16 years old, please ensure that you have received consent from your parent or guardian for any non-essential cookies.
Your privacy is important to us. You can adjust your cookie settings at any time. For more information about how we use data, please read our privacy policy. You may change your preferences at any time by clicking on the settings button below.
Note that if you choose to disable some types of cookies, it may impact your experience of the site and the services we are able to offer.
Some required resources have been blocked, which can affect third-party services and may cause the site to not function properly.
This website uses cookies to enhance your browsing experience and ensure the site functions properly. By continuing to use this site, you acknowledge and accept our use of cookies.
