First, we made an incision via an ilioinguinal
approach and resected the pseudotumor enveloped in the iliac muscle (Figure 2(a)).
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 distance between the pubic symphysis and the AOA has significance for surgeons during an anterior boarding to the acetabulum, as may be encountered with that vessel between 40 and 96 mm lateral to the pubic symphysis, although this potential danger should not compromise the surgical decision to operate through the ilioinguinal
approach for fear of excessive bleeding, since it does not appear to be a significant clinical risk (Darmanis et al.).
Pain may radiate to the proximal thigh, perineum, lower abdomen, inguinal ligament, or testicles as a result of irritation of the ilioinguinal
, genitofemoral, or obturator nerves.
2) The ilioinguinal
nerve is identified, divided, and then separated by about 2 cm.
The iliohypogastric and ilioinguinal
nerves are also at risk for injury with laterally placed trocars through direct trauma or nerve entrapment.
The pain pathways of the cervix are adrenergic excitory nerve fibers derived from Frankenhauser's parasympathetic plexus, S2--4.(28) Intracervical branches terminate at the level of the internal os(29) after traveling through the iliohypogastric, ilioinguinal
, uterosacral, and paracervical branches where they can be stimulated by mechanical, chemical, thermal, or electrical stimuli.(30)(31) The pain of cryosurgery is mediated through unmyelinated C fibers, which transmit pain in proportion to the temperature gradient and the duration of exposure to the temperature gradient developed at the surface of the cervix.(26)(32)
and the iliohypogastric nerves are generally injured during the elevation of the external oblique fascial flaps for fixation of mesh, while the genitofemoral nerve is most likely to be injured during the isolation of the cord and stripping of the cremasteric muscle fibres in Lichtenstein repair.
After informing the parents about the severity of the situation with the possibility of avascular necrosis of the femoral head (AVN) due to delay in reduction, the patient was transferred to the operating room, where a classic ilioinguinal
approach was done [8, 9].
Este evento y la posterior retraccion de los vasos hacia la cavidad pelvica, pueden ocurrir en fracturas del pubis o durante intervenciones quirurgicas que involucran la parte inferior de la pared abdominal anterior, tales como herniorrafias inguinales y femorales, cistectomias radicales, accesos anteriores al acetabulo como el ilioinguinal
o el intrapelvico, procedimientos para el tratamiento de la incontinencia urinaria de esfuerzo como la TVT Secur y otras maniobras quirurgicas que involucran la region retropubica (Darmanis et al Mahato; Stavropoulou-Deli & Anagnostopoulou; Smith et al.; Karakurt et al., 2002; Sarikcioglu & Sindel, 2002).