![]() A positive Carnett test, in which tenderness stays the same or worsens when the patient tenses the abdominal muscles, suggests abdominal wall pain. Abdominal wall pain should be suspected in patients with no symptoms or signs of visceral etiology and a localized small tender spot. This condition typically presents with acute or chronic localized pain at the lateral edge of the rectus abdominis that worsens with position changes or increased abdominal muscle tension. Anterior cutaneous nerve entrapment syndrome is the most common and frequently missed type of abdominal wall pain. ![]() Common causes of abdominal wall pain include nerve entrapment, hernia, and surgical or procedural complications. Those evaluations generally are nondiagnostic, and lingering pain can become frustrating to the patient and clinician. Abdominal wall pain is often mistaken for intra-abdominal visceral pain, resulting in expensive and unnecessary laboratory tests, imaging studies, consultations, and invasive procedures.
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