Advertisement

Intercostal Nerve Entrapment: Abdomen

  • Sola OlamikanEmail author
  • Amitabh Gulati
  • Andrea M. Trescot

Abstract

Intercostal nerve entrapment is rarely considered as a cause of abdominal wall pain, even though the pain is usually dermatomal in nature and therefore should be readily apparent. A history of lower chest or upper abdominal injury (trauma, surgery, or infection) should alert the clinician to the possibility of intercostal neuralgia.

Keywords

Intercostal neuralgia Intercostal nerve entrapment Intercostal nerve syndrome Subgastric neuralgia Subcostal neuralgia Abdominal wall pain Anterior cutaneous nerve entrapment (ACNE) syndrome 

Supplementary material

Video 39.1

Physical exam of the intercostal nerves (MOV 49860 kb)

Video 39.2

Landmark-guided injection of the intercostal nerves (MOV 51892 kb)

References

  1. 1.
    Trejo-Gabriel-Galan JM, Macarron-Vicente JL, Lazaro L, Rodriguez-Pascual L, Calvo I. Intercostal neuropathy and pain due to pleuritis. Pain Med. 2013;14(5):769–70.CrossRefPubMedGoogle Scholar
  2. 2.
    Carnett JB. Intercostal neuralgia as a cause of abdominal pain and tenderness. Surg Gynecol Obstet. 1926;42:625.Google Scholar
  3. 3.
    Carnett JB. The simulation of gallbladder disease by intercostal neuralgia of the abdominal wall. Ann Surg. 1927;86(5):747–57.CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Haynsworth Jr RF, Noe CE. An unusual presentation of intercostal neuralgia. Anesthesiology. 1990;73(4):779–80.CrossRefPubMedGoogle Scholar
  5. 5.
    Carnett JB, Bates W. The treatment of intercostal neuralgia of the abdominal wall. Ann Surg. 1933;98(5):820–9.CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Davies F, Gladstone RJ, Stibbe EP. The anatomy of the intercostal nerves. J Anat. 1932;66(Pt 3):323–33.PubMedPubMedCentralGoogle Scholar
  7. 7.
    Trescot AM. Shingles and interventional pain treatment. ASIPP News. 2006(Fall):22–3.Google Scholar
  8. 8.
    Oesch A, Kupfer K, Bodoky A. Intercostal nerve syndrome. Swiss Surg = Schweizer Chirurgie = Chirurgie suisse =Chirurgia svizzera. 2001;7(2):82–5.CrossRefPubMedGoogle Scholar
  9. 9.
    Rogers ML, Henderson L, Mahajan RP, Duffy JP. Preliminary findings in the neurophysiological assessment of intercostal nerve injury during thoracotomy. Eur J Cardiothorac Surg: Off J Eur Assoc Cardiothorac Surg. 2002;21(2):298–301.CrossRefGoogle Scholar
  10. 10.
    Wildgaard K, Ravn J, Kehlet H. Chronic post-thoracotomy pain: a critical review of pathogenic mechanisms and strategies for prevention. Eur J Cardiothorac Surg: Off J Eur Assoc Cardiothorac Surg. 2009;36(1):170–80.CrossRefGoogle Scholar
  11. 11.
    Nguyen JT, Buchanan IA, Patel PP, Aljinovic N, Lee BT. Intercostal neuroma as a source of pain after aesthetic and reconstructive breast implant surgery. J Plast Reconstr Aesthet Surg. 2012;65(9):1199–203.CrossRefPubMedGoogle Scholar
  12. 12.
    Gimenez-Mila M, Busquets C, Ojeda A, Fauli A, Moreno LA, Videla S. Neuropathic pain with features of complex regional syndrome in the upper extremity after herpes zoster. Pain Pract. 2014;14(2):158–61.CrossRefPubMedGoogle Scholar
  13. 13.
    Johnson ER, Powell J, Caldwell J, Crane C. Intercostal nerve conduction and posterior rhizotomy in the diagnosis and treatment of thoracic radiculopathy. J Neurol Neurosurg Psychiatry. 1974;37(3):330–2.CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Pradhan S, Taly A. Intercostal nerve conduction study in man. J Neurol Neurosurg Psychiatry. 1989;52(6):763–6.CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Chen SM, Chen JT, Kuan TS, Hong CZ. Myofascial trigger points in intercostal muscles secondary to herpes zoster infection of the intercostal nerve. Arch Phys Med Rehabil. 1998;79(3):336–8.CrossRefPubMedGoogle Scholar
  16. 16.
    Sakai F, Sone S, Kiyono K, Imai S, Izuno I, Oguchi M, et al. High resolution ultrasound of the chest wall. RoFo: Fortschr Gebiete Rontgenstrahlen Nuklearmedizin. 1990;153(4):390–4.CrossRefGoogle Scholar
  17. 17.
    Green CR, de Rosayro AM, Tait AR. The role of cryoanalgesia for chronic thoracic pain: results of a long-term follow up. J Natl Med Assoc. 2002;94(8):716–20.PubMedPubMedCentralGoogle Scholar
  18. 18.
    Engel AJ. Utility of intercostal nerve conventional thermal radiofrequency ablations in the injured worker after blunt trauma. Pain Physician. 2012;15(5):E711–8.PubMedGoogle Scholar
  19. 19.
    Garcia Cosamalon PJ, Mostaza A, Fernandez J, Vinuela J, Mazabel M, Costilla S, et al. Dorsal percutaneous radiofrequency rhizotomy guided with CT scan in intercostal neuralgias. Technical note. Acta Neurochir (Wien). 1991;109(3–4):140–1.CrossRefGoogle Scholar
  20. 20.
    Akkaya T, Ozkan D. Ultrasound-guided pulsed radiofrequency treatment of the intercostal nerve: three cases. J Anesth. 2013;27(6):968–9.CrossRefPubMedGoogle Scholar
  21. 21.
    Boelens OB, van Assen T, Houterman S, Scheltinga MR, Roumen RM. A double-blind, randomized, controlled trial on surgery for chronic abdominal pain due to anterior cutaneous nerve entrapment syndrome. Ann Surg. 2013;257(5):845–9.CrossRefPubMedGoogle Scholar
  22. 22.
    Williams EH, Williams CG, Rosson GD, Heitmiller RF, Dellon AL. Neurectomy for treatment of intercostal neuralgia. Ann Thorac Surg. 2008;85(5):1766–70.CrossRefPubMedGoogle Scholar
  23. 23.
    Samlaska S, Dews TE. Long-term epidural analgesia for pregnancy-induced intercostal neuralgia. Pain. 1995;62(2):245–8.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  • Sola Olamikan
    • 1
    • 2
    Email author
  • Amitabh Gulati
    • 3
  • Andrea M. Trescot
    • 4
  1. 1.Department of Anesthesiology and Pain MedicineUniversity of Texas, Southwestern Medical CenterDallasUSA
  2. 2.Children’s Health Medical CenterDallasUSA
  3. 3.Anesthesiology and Critical CareMemorial Sloan Kettering Cancer CenterNew YorkUSA
  4. 4.Pain and Headache CenterAnchorageUSA

Personalised recommendations