Groin pain in the absence of hernia: a new syndrome |
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Authors: | M Deysine G Deysine W Reed |
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Institution: | (1) Department of Surgery, Winthrop University Hospital, Mineola, N.Y., USA,;(2) Department of Orthopedics, Virginia Mason Clinic, Seattle, WA, USA,;(3) Present address: 2000 North Village Ave., Rockville Centre, NY 11570, USA, |
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Abstract: | Abstract
Abstract. Groin pain may be produced by a true hernia, trauma to the groin structures or peripheral nerve, or root compression at various
levels. Approximately 4,000 patients underwent inguinal herniorrhaphy (group A). An additional 134 patients complaining of
groin pain and exhibiting no evidence of primary or recurrent hernia fell into two categories: 30 patients who had a previous
herniorrhaphy (group B) and 104 patients without previous surgery (group C). Group B patients underwent a diagnostic nerve
block which, when positive, suggested ilioinguinal nerve compromise at the wound. Those who failed conservative measures underwent
nerve division. Group C patients were advised to decrease recreational and occupational activities; if that failed, they underwent
lumbosacral spine imaging. There were no neuralgias in group A. Eight group B patients responded to conservative measures;
the 22 others required ilioinguinal nerve division which relieved their pain. In group C, 42 patients responded to physical
activity restriction plus NSAIDs; the remaining 62 underwent imaging which revealed lumbosacral bone pathology producing root
compression and were referred to orthopedists. Lumbosacral spine pathology should be suspected in patients who complain of
groin pain in the absence of hernia or previous herniorrhaphy. Recognition of this syndrome may avoid negative exploratory
herniorrhaphies.
Electronic Publication |
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Keywords: | Groin pain Inguinal hernia Inguinal herniorrhaphy Ilioinguinal nerve neuralgia |
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