ilioinguinal nerve trunk pain
Introduction
Introduction to sacral inguinal neuralgia Clinically more common, and more than 80% are iatrogenic, mostly after surgery related to the nerve, especially after sacral bone removal, and even some patients think that the pain is more than the original disease Unbearable, should attract attention. The nerve originates from the lumbar 1 spinal nerve and runs parallel to the underside of the infraorbital nerve. After the outer edge of the psoas muscle, the anterior superior iliac spine is crossed over the lumbar muscle and passes through the transverse abdominis muscle and the internal oblique muscle. The sacral or uterine round ligament is advanced to the inguinal canal under the aponeurosis of the external oblique muscle. At the shallow ring, the external oblique aponeurosis is worn out and the final branch is separated. 1. Skin branch: distributed in the pubic part, the groin, the upper part of the medial side of the femoral sac and the anterior part of the scrotum (large labia majora). 2. Muscle branch: distributed to the abdominal muscles of the lower abdomen. basic knowledge The proportion of illness: 0.005% Susceptible people: no specific population Mode of infection: non-infectious Complications: femoral neuralgia
Cause
Causes of inguinal hernia
Trauma (30%):
In addition to the direct violence and the athlete's abdominal muscles, the anterior superior iliac spine is more common when the pelvic fracture occurs, mainly due to the stimulation of the nerve by the hematoma. This shows that the history of trauma caused the main cause of the disease.
Lower abdominal surgery (20%):
In the lower abdomen surgery, many injuries are caused, such as the appendectomy, sacral repair, etc., such as traction, cutting or postoperative scar contraction, causing contusion or fracture. Surgery in the lower abdomen is also a major cause of this disease.
Tibial surgery (20%):
More common in the humeral cutting surgery accidental injury, or the injury to the humerus itself and postoperative infusion pressure.
Other (10%):
Such as local inflammation, tumors, etc., generally less.
Prevention
Inguinal hernia pain prevention
Avoid injury to the lower abdomen and tibial surgery and the athlete's abdominal activity.
Complication
Complications of inguinal hernia Complications, femoral neuralgia
Complications of this disease may include sciatica and femoral neuralgia.
Symptom
Inguinal hernia pain symptoms Common symptoms Postoperative pain inguinal pain Lower extremity neuropathic pain
1. Pain and tenderness
Most of the pain in the upper anterior iliac spine is downward, which reaches the scrotum and is accompanied by tenderness, which is exacerbated by coughing.
2. Abdominal muscle contracture
The lower abdominal muscles that are dominated by the pain are in a contracted or paralyzed state, and the hip joints are in a flexion, adduction, and the gait becomes smaller when walking.
Examine
Examination of the inguinal hernia
1. Check:
Perform MRI and CT examination of the affected area in time.
2. Clinical symptom check:
Pain, tenderness, abdominal muscle condition and gait.
3. Closed test
The nerve was blocked by 10% to 15 ml of 1% procaine, and the symptoms disappeared or reduced. During operation, the surgeon punctures the needle tip between the intra-abdominal oblique muscle and the transverse abdominis muscle to the inner wall of the tibia. The drug is injected in a fan shape, so be careful not to go too deep to avoid entering the abdominal cavity.
Diagnosis
Diagnosis and differential diagnosis of inguinal hernia
Diagnostic criteria
1. History of trauma: including surgery.
2. Clinical symptoms: pain, tenderness, abdominal muscle condition and gait.
3. Closed test: The nerve was blocked by 10% 15% of procaine, and the symptoms disappeared or reduced. In operation, the surgeon placed the needle tip between the abdominal oblique muscle and the transverse abdominis muscle. Spurs the inner wall of the tibia and injects the drug in a fan shape. Be careful not to go too deep to avoid entering the abdominal cavity.
Differential diagnosis
This disease is generally not confused with other diseases.
