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Re: "Nerve Entrapment"From: DoctorJoe@aol.comFri Sep 14 09:50:37 2007
In a message dated 9/14/2007 7:49:07 A.M. Central Daylight Time, apgar10@thebirthcentermt.com writes: Over the past couple of weeks, in our facility, there have been two patients who have been taken back to the OR following a cesarean section, for “nerve entrapment†in the cesarean incision, causing severe pain. Maybe it is because I have only been doing this for 19 years, not counting residency, but I have never heard of this. As a matter of fact, I think I can say that “nerve entrapment†wouldn’t even enter my differential for severe pain following a cesarean section. Can someone enlighten me here – has anybody else heard of this. Distant from any surgery, following scar formation, with significant, persistent incisional pain, I have considered “nerve entrapmentâ€, but not in the first few days following surgery… I've seen it in GYN. If you go out wide on a Pfannenstiel (or if you do a whole case with your elbow resting on the patient's side), you can injure the ilioinguinal nerve, I believe (or was it the genitofemoral? Or do they branch from the same root?). I'd have to google the anatomy but I can't right now. But the point of interest would be long the lateral abdomen where you might bag the nerve or at least get it really mad. Joe P.
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