What causes ilioinguinal (lower abdominal and groin area) pain?

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Last updated: February 18, 2025View editorial policy

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Differential Diagnosis for Ilioinguinal Pain

  • Single Most Likely Diagnosis
    • Inguinal hernia: This is a common cause of ilioinguinal pain, especially in men. The pain is often exacerbated by coughing, lifting, or straining, and may be accompanied by a palpable mass in the groin area.
  • Other Likely Diagnoses
    • Ilioinguinal neuralgia: This condition involves irritation or damage to the ilioinguinal nerve, which runs through the inguinal canal. It can cause sharp, stabbing pain in the groin area, often radiating to the inner thigh.
    • Ovarian cysts or torsion (in women): Ovarian cysts can cause ilioinguinal pain, especially if they rupture or become twisted. This condition requires prompt medical attention to prevent complications.
    • Kidney stones: Stones in the ureter can cause severe, crampy pain that radiates to the groin area, often accompanied by nausea, vomiting, and urinary frequency.
    • Musculoskeletal strain: Strain or injury to the muscles in the lower back or groin area can cause ilioinguinal pain, especially after heavy lifting or physical activity.
  • Do Not Miss Diagnoses
    • Appendicitis: Although the pain of appendicitis typically starts near the navel and then moves to the lower right abdomen, it can sometimes radiate to the groin area. Missing this diagnosis can lead to serious complications, including perforation and peritonitis.
    • Ectopic pregnancy (in women): This is a life-threatening condition in which a fertilized egg implants outside the uterus, often causing severe abdominal and pelvic pain, including ilioinguinal pain.
    • Testicular torsion (in men): This is a medical emergency in which the spermatic cord becomes twisted, cutting off blood flow to the testicle. It requires prompt surgical intervention to prevent testicular loss.
  • Rare Diagnoses
    • Retroperitoneal fibrosis: This is a rare condition in which fibrotic tissue forms in the retroperitoneum, potentially compressing or invading nearby structures, including nerves and blood vessels.
    • Iliopsoas abscess: This is a rare condition in which an abscess forms in the iliopsoas muscle, often as a result of bacterial infection. It can cause ilioinguinal pain, fever, and other systemic symptoms.
    • Nerve root compression: Compression of the nerve roots in the lumbar spine can cause ilioinguinal pain, especially if the L1 or L2 nerve roots are involved. This can be due to various causes, including herniated discs or spinal stenosis.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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