Peripheral Nerve Injuries Resulting From Common Surgical Procedures in the Lower Portion of the Abdomen

P Stulz

Archives of Surgery · 1982 · 127 citations · 5 references

Concepts

TL;DR

Ilioinguinal and iliohypogastric nerve entrapment can occur after common lower abdominal surgeries, presenting with burning pain radiating from the incision, sensory loss, and relief by local anesthetic infiltration. The study aims to assess the effectiveness of scar repair with resection of the compromised nerve for treating postoperative nerve entrapment. The intervention involved surgical scar repair and resection of the affected ilioinguinal/iliohypogastric nerve. Sixteen of 23 patients became symptom‑free after neurectomy, while seven continued to experience chronic scar pain. Arch Surg 1982;117:324‑327.

Abstract

• Twenty-three patients had a painful ilioinguinal and/or iliohypogastric nerve entrapment syndrome following common surgical procedures in the lower portion of the abdomen (appendectomy, repair of inguinal hernia, and gynecologic procedures through transverse incision). The diagnostic triad of nerve entrapment after operation comprises (1) typical burning or lancinating pain near the incision that radiates to the area supplied by the nerve, (2) clear evidence of impaired sensory perception of the nerve, and (3) pain relieved by infiltration with anesthetic for local effects at the site where the two nerves leave the internal oblique muscle. Surgical repair of the scar with resection of the compromised nerve is the most effective treatment. Sixteen patients became symptom free after neurectomy, seven still suffer chronic pain in the scar. (<i>Arch Surg</i>1982;117:324-327)

References

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