2018, Number 3
Acta Med 2018; 16 (3)
Ilioinguinal nerve entrapment syndrome
Funes RJF, Domínguez GLG, Ramme CC, Domínguez CLG
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Ilioinguinal nerve entrapment syndrome is an abdominal muscular pain, 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.
A 19 years old male with eight months of evolution characterized by chronic burning abdominal pain located on right iliac fossa with radiation to internal fifth of inguinal ligament, right root of penis and upper zone of scrotal bag, on 7 in analogue visual scale, permanent, and exacerbated by Valsalva maneuver. Physical: Positive Carnett sign, allodynia and hyperesthesia on ipsilateral scrotal bag and penis root.
Ilioinguinal nerve entrapment syndrome can be treated by infiltration of a local anaesthetic confirming the diagnosis. Knowledge of this syndrome prevents unnecessary investigation.
Koop H, Koprdova S, Schürmann C. Chronic abdominal wall pain. Dtsch Arztebl Int. 2016; 113 (4): 51-57.
Srinivasan R, Greenbaum DS. Chronic abdominal wall pain: a frequently overlooked problem. Practical approach to diagnosis and management. Am J Gastroenterol. 2002; 97 (4): 824-830.
Van Assen T, Brouns JA, Scheltinga MR, Roumen RM. Incidence of abdominal pain due to the anterior cutaneous nerve entrapment syndrome in an emergency department. Scand J Trauma Resusc Emerg Med. 2015; 23: 19-25.
Akhnikh S, de Korte N, de Winter P. Anterior cutaneous nerve entrapment syndrome (ACNES): the forgotten diagnosis. Eur J Pediatr. 2014; 173 (4): 445-449.
Solmaz I, Talay M, Tekindur Ş, Kurt E. A commonly seen cause of abdominal pain: abdominal cutaneous nerve entrapment syndrome. Agri. 2012; 24 (3): 139-141.
Neel Amin N, Krashin D, Trescot MA. Ilioinguinal and iliohypogastric nerve entrapment. In: Trescot MA. Editor. Abdomina. Peripheral Nerve Entrapments. Springer International Publishing. 2016, pp. 413-424.
Ter Meulen BC, Peters EW, Wijsmuller A, Kropman RF, Mosch A, Tavy DL. Acute scrotal pain from idiopathic ilioinguinal neuropathy: diagnosis and treatment with EMG-guided nerve block. Clin Neurol Neurosurg. 2007; 109 (6): 535-537.
Wang H, Gross S. Positive predictive value of Carnett’s sign in differential diagnosis of chronic abdominal pain: a retrospective cohort study. J Pain. 2013; 14 (4): S8.
Boelens OB, Scheltinga MR, Houterman S, Roumen RM. Management of anterior cutaneous nerve entrapment syndrome in a cohort of 139 patients. Ann Surg. 2011; 254 (6): 1054-1058.
Scheltinga MR, Boelens OB, Tjon A Ten WE, Roumen RM. Surgery for refractory anterior cutaneous nerve entrapment syndrome (ACNES) in children. J Pediatr Surg. 2011; 46 (4): 699-703.