ilioinguinal nerve injury

Last reviewed 01/2018

Ilioinguinal nerve

  • ilioinguinal nerve originates from the T12 and L1 nerve roots
    • sensory area supplied
      • pubic symphysis and the superomedial aspect of the femoral triangle receive a sensory supply from this nerve

  • ilioinguinal nerve entrapment syndrome is an abdominal muscular pain syndrome, characterized by the clinical triad of muscular type iliac fossa pain with a characteristic radiation pattern, an altered sensory perception in the ilioinguinal nerve cutaneous innervation area, and a well-circumscribed trigger point medial and below the anterosuperior iliac spine. Relief of pain by infiltration of a local anaesthetic confirms the diagnosis

    • ilioinguinal nerve can be injured during surgical approaches to the lower abdomen, during pregnancy and bone graft harvesting from the iliac region
      • nerve entrapment can occur at the point where it passes through the transversus abdominis and internal oblique muscles medial to the anterosuperior iliac spine (ASIS)
      • nerve injury can also occur with tearing of the lower external oblique aponeurosis
      • diagnosis of nerve injury is made clinically
        • neuropathy of the ilioinguinal nerve has three characteristics; pain, altered sensation and the presence of a trigger point
          • pain
            • occurs in the iliac fossa and radiates to the groin, scrotum or labia majora, the proximal medial aspect of the thigh and the back
          • altered sensation may be hyper-,hyo- or dysaesthesia
          • trigger point is present medial and distal to the ASIS
        • patient walks with a flexed trunk gait
          • provocative testing involves hip extension
          • also palpation of the inguinal canal or medial to the ASIS may reproduce these symptoms
      • local aesthetic injection can aid diagnosis as it is difficult to differentiate the pain caused by the iliohypogastric, ilioinguinal and genitofemoral nerves due to the overlap of sensory innervation

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