Iliohypogastric nerve entrapment

We present a case report of a consult for a gynecologic patient who presented with unrelenting postsurgical pain and previously underwent laparoscopic surgery. Given the pain distribution, we hypothesized the patient had an ilioinguinal or iliohypogastric nerve entrapment injury. We performed a diagnostic and therapeutic ilioinguinal and iliohypogastric nerve block, alleviating the patient's pain. The patient returned to the operating room to release a fascial stitch, permanently relieving the pain. This is a reminder that anesthesiologists can use regional anesthesia for both diagnosis and treatment...

RATIONALE: Diagnosing the precise etiology of low back pain (LBP) is crucial for facilitating speedy recovery in patients. Maigne's syndrome (MS), commonly referred to as thoracolumbar junction syndrome, is a condition characterized by pain resulting from nerve entrapment, yet its underlying mechanisms remain poorly understood. This study presents a series of six case reports wherein patients diagnosed with MS received acupuncture treatment. PATIENT CONCERNS: Six individuals with LBP were included in the study, and all were diagnosed with MS...

BACKGROUND: To describe the experience in the diagnostic process and treatment of patients with groin pain (GP) of neurological origin due to entrapment of the iliohypogastric (IH), ilioinguinal (IL) and genitofemoral (GF) nerves in a hip preservation clinic. METHODS: Retrospective study of patients with GP of neurological origin confirmed with ultrasound-guided nerve block. Clinical outcomes were reported in 21 cases (age, 53.3 ± 15.9 years) treated with conservative treatment from January to December 2019, and in 9 patients (age 43...

Introduction To date, Lichtenstein tension-free mesh hernioplasty is being adopted widely for inguinal hernia repair in adults, although it is accompanied by procedural complications such as recurrences, infection, testicular atrophy, post-operative pain, and nerve injury. As the recurrence rate decreased after Lichtenstein's tension-free hernioplasty, surgeons' point of focus shifted more toward postoperative groin pain (inguinodynia) after inguinal hernia repair, as it has become a quite significant problem...

Entrapment of the iliohypogastric nerve is a rare cause of abdominal pain in children. We present a case report of a 12 year old girl with abdominal pain following a fall accompanied by nausea, vomiting and odynuria. Thorough investigation was normal and a non-organic cause was proposed. With no lasting improvement after local analgesic infiltration, a surgical attempt to disconnect sensory innervation was conducted but pain continued. A second surgical exploration was performed. A tear of the external oblique aponeurosis was found, entrapping terminal branches of the iliohypogastric nerve...

PURPOSE OF REVIEW: This is a comprehensive review of the literature regarding post-surgical cutaneous nerve entrapment, epidemiology, pathophysiology, and clinical presentation. It focuses mainly on nerve entrapment leading to chronic pain and the available therapies. RECENT FINDINGS: Cutaneous nerve entrapment is not an uncommon result (up to 30% of patients) of surgery and could lead to significant, difficult to treat chronic pain. Untreated, entrapment can lead to neuropathy and damage to enervated structures and musculature, and significant morbidity and financial loss...

Iliohypogastric neuralgia is an uncommon etiology of lower abdominal pain caused by entrapment of the iliohypogastric nerve. Conventional management consists of medications, injections, and surgery; previous literature has not explored the use of osteopathic manipulative medicine for management of iliohypogastric neuralgia. Here, the author discusses the case of a 72-year-old woman who presented with 2 years of right lower abdominal pain, having failed multiple treatments, including exploratory laparoscopy and appendectomy...

To determine the outcomes of a limited surgical intervention, consisting of neurolysis, inguinal wall repair and/or adductor debridement of adhesions based on intraoperative findings. Retrospective case series. Outpatient orthopedic/general surgery clinic. Fifty-one athletes treated surgically for inguinal-related groin pain from 2009 to 2015. Limited surgical intervention, consisting of neurolysis, inguinal wall repair and/or adductor debridement based on intra-operative findings. Ability to return to sport at the same level, time to return to play...

Chronic neuropathic pain due to iliohypogastric (IH) or ilioinguinal (IL) nerve entrapment or injury may demonstrate as referred pain to the genito-urinary organs. Our patient is a 67-year-old woman who presented with a 9-month history of bladder pain, dyspareunia and nocturia that all began following a laparoscopic pyeloplasty. This report describes improvement of bladder pain syndrome following surgical resection of the II and IH nerves.

OBJECTIVE: Up to 8% of patients undergoing surgery via a Pfannenstiel incision may develop chronic inguinal pain. This type of pain is frequently caused by inguinal nerve entrapment and may strongly interfere with daily functioning. We report our long term experience of a step up approach using tender point infiltration and surgical neurectomy for intractable neuropathic post-Pfannenstiel groin pain. STUDY DESIGN: A retrospective database analysis identified patients with neuropathic groin pain due to iliohypogastric and/or ilioinguinal nerve entrapment following a Pfannenstiel incision in a single center between 2000 and 2015...

BACKGROUND: Neuralgia due to iliohypogastric nerve entrapment from sutures and mesh after inguinal hernioplasty is a rare entity in clinic. Its' awareness and management remain a clinical challenge. CASE PRESENTATION: We report a case of 54-year-old male who presented with post-operative pain after 1 month and sensory disturbances of the right lower limb. He underwent partial neurectomy and during the surgery it was found that there was injury to iliohypogastric nerve due to entrapment from sutures and mesh...

Chronic pelvic pain is a disabling condition that affects a large number of men and women. It may occur after a known inciting event, or it could be idiopathic. A common cause of pelvic pain syndrome is neuropathy of the pelvic nerves, including the femoral and genitofemoral nerves, ilioinguinal and iliohypogastric nerves, pudendal nerve, obturator nerve, lateral and posterior femoral cutaneous nerves, inferior cluneal nerves, inferior rectal nerve, sciatic nerve, superior gluteal nerve, and the spinal nerve roots...

BACKGROUND: Chronic post-operative inguinodynia occurs in about 10 % of patients undergoing inguinal hernioplasty with prosthesis; it is characterized by a broad pleomorphism of symptoms, including relative to individual variability of algic perception. Its intensity can also potentially jeopardize patient's work and social activities. The most notorious cause of inguinodynia is neuropathy, resulting from the involvement of one or more inguinal nerves (iliohypogastric, ilioinguinal and genitofemoral nerves) in fibroblastic processes, or from nervous stimulation, caused by prosthetic material on adjacent nervous trunks...

STUDY OBJECTIVE: To determine the incidence and clinical significance of iliohypogastric-ilioinguinal neuropathy from lower abdominal lateral port placement and fascial closure during laparoscopic gynecologic surgery. DESIGN: Retrospective cohort study (Canadian Task Force classification II-2). SETTING: University-based referral center specializing in minimally invasive gynecologic surgery and chronic abdominopelvic pain. PATIENTS: Women who underwent a laparoscopic procedure because of benign gynecologic indications during a 3-year study period from 2008 to 2011...

INTRODUCTION: Chronic pelvic and perineal pain can be related to a nerve lesion caused by direct or indirect trauma or by an entrapment syndrome, which must then be demonstrated by a test block. The purpose of this article is to review the techniques and modalities of somatic nerve block in the management of chronic pelvic and perineal pain. MATERIAL AND METHODS: A review of the literature was performed by searching PubMed for articles on somatic nerve infiltrations in the management of chronic pelvic and perineal pain...

BACKGROUND: Chronic neuropathy after hernia repair is a neglected problem as very few patients are referred for surgical treatment. The aim of the present study was to assess the outcome of standardized surgical revision for neuropathic pain after hernia repair. METHODS: In a prospective cohort study we evaluated all patients admitted to our tertiary referral center for surgical treatment of persistent neuropathic pain after primary herniorrhaphy between 2001 and 2006...

OBJECTIVE: The authors assessed the long-term pain relief after local nerve blocks or neurectomy in patients suffering from chronic pain because of Pfannenstiel-induced nerve entrapment. SUMMARY BACKGROUND DATA: The low transverse Pfannenstiel incision has been associated with chronic lower abdominal pain because of nerve entrapment (2%-4%). Treatment options include peripheral nerve blocks or a neurectomy of neighboring nerves. Knowledge on adequate (surgical) management is scarce...

BACKGROUND: Ilioinguinal nerve entrapment is one of the most common nerve injuries following pelvic surgery. We present a case of intractable right lower quadrant pain successfully treated with neurectomy. CASE: A 31-year-old woman, following her third elective cesarean section, noted intense, right inguinal pain immediately upon awaking from anesthesia. The pain was burning and constant and exacerbated by standing and movement. After a period of failed conservative management, a workup concluded probable nerve entrapment...

OBJECTIVE: To estimate the incidence, etiology, and outcome of neuropathies after major gynecologic surgery and to recommend management and prevention strategies for these complications. METHODS: The medical records of women who suffered neuropathy after major pelvic surgery between July 1995 and June 2001 were reviewed. Mechanism of injury, treatment, and outcome were determined from the patient charts. RESULTS: Twenty-three of 1210 patients undergoing major pelvic surgery during the defined period suffered a postoperative neuropathy for an incidence of 1...

BACKGROUND: An approach to surgical management of the patient with groin pain is described based on our experience with 54 patients, six of whom had bilateral symptoms. History and physical examination are sufficient to relate the pain to one or more of the lateral femoral cutaneous (LFC), ilioinguinal (II), iliohypogastric (IH), or genitofemoral (GF) nerves. STUDY DESIGN: Retrospective analysis of patients with groin pain is reported, with emphasis on cause, involved nerves, and outcomes of operative management...