Peripheral nerve injuries resulting from common surgical procedures in the lower portion of the abdomen
P. Stulz and K. M. Pfeiffer
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.
