Six months after an uncomplicated open inguinal hernia repair, a patient reports persistent burning pain in the groin radiating to the scrotum and medial thigh, aggravated by hip extension. Which nerve is most commonly implicated in chronic post-herniorrhaphy inguinal pain?

• A Ilioinguinal nerve ✓
• B Subcostal nerve
• C Pudendal nerve
• D Lateral femoral cutaneous nerve

Explanation

Chronic post-herniorrhaphy groin pain results most often from entrapment, tethering, or transection of the ilioinguinal nerve, which runs on the anterior surface of the spermatic cord in the canal. Its sensory territory matches the described distribution. The iliohypogastric and genital branch of the genitofemoral nerve are next in frequency, while the lateral femoral cutaneous nerve causes meralgia paraesthetica on the anterolateral thigh, unrelated to hernia repair.

Reference: Bailey and Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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