The 12th thoracic, iliohypogastric and ilioinguinal nerves
were blocked by injection of 10 to 15 ml of anaesthetic solution deep to external oblique aponeurosis 1.5 cm medial and superior to the anterior superior iliac spine.
In the differential diagnosis, bladder syndrome, vulvodynia, levator myalgia, piriformis syndrome, coxodynia, cauda equina syndrome, neuralgias and inflammation of other nerves such as obturator, genitofemoral, or ilioinguinal nerves
should be considered.
In our case, the patient had a L1 nerve root compression, the ventral ramus of LI divides into iliohyoogastric and ilioinguinal nerves
, both in charge of supplying the innervation of the lower segments of the transversus abdominis and the internal and external oblique muscle.
Additionally, the spinal nerves, comprising T11 (the 11th intercostal nerve), T12 (the subcostal nerve), and L1 (iliohypogastric and ilioinguinal nerves
) were localized, and the staining of these nerves was evaluated.
The L1 spinal nerve divides into the iliohypogastric and ilioinguinal nerves
, which innervate the skin of the gluteal region behind the lateral cutaneous branches of T12, the hypogastric region, the upper medial part of the thigh, and the genital area .
The iliohypogastric and ilioinguinal nerves
are also at risk for injury with laterally placed trocars through direct trauma or nerve entrapment.
Nerves that respond well to freezing include the ilioinguinal nerves
, intercostal nerves and superficial femoral nerves.
The goal of orchiectomy is to relieve orchialgia by releasing the entrapped ipsilateral genitofemoral and/or ilioinguinal nerves
. One study determined that 90% of men who underwent unilateral epididymectomy for chronic orchialgia required an orchiectomy to resolve pain.
The nerve supply to these muscles is derived from the lower thoracic nerves, via the lower intercostal, subcostal, iliohypogastric and ilioinguinal nerves
Knowledge of the variations in the course of the iliohypogastric and ilioinguinal nerves
is of practical clinical importance.
The investigators located the entrance and termination points of 13 iliohypogastric and 16 ilioinguinal nerves
, devising nerve maps to show their course in individuals and the group as a whole.
These include the intercostal nerves (T7-T11), the subcostal nerve (T12), and the iliohypogastric and ilioinguinal nerves