Learning objectives
To describe the landmarks on ultrasound to identify the ilioinguinal,
iliohypogastric,
genitofemoral,
obturator and pudendal nerve,
enabling ultrasound-guided diagnostic or therapeutic infiltration.
Background
The ilioinguinal,
iliohypogastric,
genitofemoral,
obturator and pudendal nerve are the major sensory nerves of the groin and may be involved in the chronic groin pain.
1.The ilioinguinal (II) nerve supplies the skin of the superomedial thigh,
the skin over the root of the penis and anterior scrotum in men and the mons pubis and labium majus in the female.
2.The iliohypogastric (IH) nerve supplies the skin over the lower part of the rectus abdominis or mons pubis.
3.The genital branch of the genitofemoral (GF) nerve...
Imaging findings OR Procedure Details
Nerve identification using the appropriate landmarks on ultrasound;
1.Ilioinguinal and iliohypogastric nerves.
-Originating from the TH12-L1 nerve roots,
both nerves run subperitoneally until they pierce the abdominal wall muscles,
at a level superior to the anterior superior iliac spine (ASIS).
At this point,
the nerves can be picked up on ultrasound.
-Landmarks: starting on the ASIS,
a linear high frequency probe is placed in a transverse plane medial to it and shifted 3 to 5 cm superior.
The muscle bellies of the internal oblique abdominal...
Conclusion
The landmarks on ultrasound described in this presentation offer an easy andpractical tool to identify the ilioinguinal,
iliohypogastric,
genitofemoral,
obturator and pudendal nerve,
enabling ultrasound-guided diagnostic or therapeutic infiltration.
References
-Philip WH Peng,Paul S Tumber.
Ultrasound-Guided Interventional Procedures for Patients with Chronic Pelvic Pain - A Description of Techniques and Review of Literature.
Pain Physician 2008; 11:215-224
-Achir A Al-Alami et all.
New Approach of Ultrasound-Guided Genitofemoral Nerve Block in Addition to Ilioinguinal/Iliohypogastric Nerve Block for Surgical Anesthesia in Two High Risk Patients: Case Report.
Open Journal of Anesthesiology 2013; 3:298-300
Personal Information
Dr.
K.
Vanderdood
Dr.
M.
Adriaensen
Dept.
of Radiology
Zuyderland Medical Center
Sittard-Geleen/Heerlen
The Netherlands
[email protected]
