[Surgery-induced abdominal wall nerve entrapment: do not overlook intensive postoperative pain]. / Leikkauksella aiheutettu vatsanpeitehermon pinne: äla vähättele kovaa leikkauksenjäkeistä kipua.

The most common cause of persistent postoperative pain after inguinal hernia repair is entrapment of a sensory nerve in the wound closure, The pain may be triggered by touching the skin, and the pain is relieved after a nerve block. In two patient cases, division of the nerve immediately terminated the pain, and the relief seemed to be permanent. Pains are common in inguinal hernia scars, but also after an appendectomy operation and Pfannenstiel's incision.

Coexisting ipsilateral right femoral hernia and incarcerated obturator hernia.

Obturator hernia (OH) is an uncommon cause of bowel obstruction and described in elderly females in the literature. The treatment has traditionally been laparotomy because of an acute nature of the condition. However, because of old age and comorbidities that OH is associated with, general anaesthesia may need to be avoided. In the current case, a transinguinal preperitoneal approach and management are presented after delayed preoperative diagnosis of bowel obstruction caused by a coexisting right incarcerated OH and ipsilateral non-reducible femoral hernia. A 91-year-old woman had a 6-day history of nausea and vomiting. She was referred to surgery because of persisting vomiting, but without any abdominal pain. A CT scan showed a hernia in the right groin area but the diagnosis was delayed. The hernias were repaired using a preperitoneal transinguinal approach. Bowel resection was not needed. The obturator canal and the femoral ring were both covered by a Bard Polysoft patch.