2022 Volume 58 Issue 1 Pages 79-84
Case: A 16-year-old girl. Medical history: nothing remarkable. Clinical presentation: She had a bulge in the right inguinal region a few weeks before and she consulted a home doctor, who referred her to our hospital with a diagnosis of inguinal hernia. A bulge in the right inguinal region was observed in the standing position, and omental prolapse was observed by surface ultrasonography. Laparoscopic percutaneous extraperitoneal closure (LPEC) was performed when she was 14. When LPEC was performed, a 5-cm-sized right ovarian swelling was observed. After the operation, she felt pain in the right inguinal region during her menstrual period, which was controlled with an analgesic. She was followed up by ultrasonography considering the effect of swelling of the right ovary on her pain. Gradually, the pain did not match her menstrual period, and we judged that the pain was due to postoperative chronic pain. We administered nerve blockers, but they were not effective. At the age of 16, triple neurectomy, resection of the round ligament, and re-suture of the internal inguinal gate were carried out by the Marcy method. After following up for around 1 year, she felt no chronic pain and was physically well. We report that triple neurectomy and resection of the round ligament are effective for chronic pain after LPEC.
