[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Anatomy](https://durgical.com/en/anatomy/) › [Spine](https://durgical.com/en/anatomy/region/spine/) › Iliohypogastric and ilioinguinal nerves [Nervous system](https://durgical.com/en/anatomy/system/nervous-system/) · [Spine](https://durgical.com/en/anatomy/region/spine/) # Iliohypogastric and ilioinguinal nerves The iliohypogastric and ilioinguinal nerves come from L1 and curve around the abdominal wall; they supply the lower abdomen and groin. [See in 3D →](https://durgical.app/?from=durgipedia&lang=en#region=spine&select=iliohypogastric_ilioinguinal_nerves&side=r) Opens in the Durgical app, no sign-up needed. ## What it is Two nerves from L1 that run around the abdominal wall above the iliac crest. ## What it does Supply the lower abdominal muscles and feeling in the lower abdomen and groin. ## Key points - Both run forward above the iliac crest between transversus abdominis and internal oblique; near the ASIS this plane is used for the ultrasound-guided block - The ilioinguinal nerve enters the inguinal canal from the side (not through the deep ring) and leaves through the superficial ring in front of the [spermatic cord](https://durgical.com/en/anatomy/spermatic-cord/) or round ligament - The nerves most often injured in open inguinal hernia repair and Pfannenstiel incisions, causing chronic groin pain or numbness ## Key facts **Roots** L1 (iliohypogastric often with T12); emerge from the lateral border of [psoas major](https://durgical.com/en/anatomy/psoas-major/), cross quadratus lumborum **Moves** Lowest fibres of internal oblique and transversus abdominis **Feeling from** Iliohypogastric: suprapubic and lateral gluteal [skin](https://durgical.com/en/anatomy/skin/); ilioinguinal: upper medial thigh, root of penis or mons, anterior [scrotum](https://durgical.com/en/anatomy/scrotum/) or labium majus ## Relations **Course** Leave the lateral border of psoas, cross the front of [quadratus lumborum](https://durgical.com/en/anatomy/quadratus-lumborum-muscle/), pierce [transversus abdominis](https://durgical.com/en/anatomy/transversus-abdominis-muscle/) near the iliac crest and run forward between it and [internal oblique](https://durgical.com/en/anatomy/internal-abdominal-oblique-muscle/); the iliohypogastric ends above the superficial ring, the ilioinguinal runs in the [inguinal canal](https://durgical.com/en/anatomy/inguinal-canal/) **In front** In the posterior [abdomen](https://durgical.com/en/anatomy/region/abdomen/), the lower pole of the [kidney](https://durgical.com/en/anatomy/kidney/) and the colon **Behind** The quadratus lumborum ## How to find it On ultrasound, a probe placed just medial to the ASIS on the line toward the umbilicus shows the three muscle layers over the iliac bone; the two nerves are small dots between internal oblique and transversus abdominis, near the deep circumflex iliac artery. ## Examination - Tenderness or tapping just medial to the ASIS that reproduces groin pain suggests entrapment; relief after a diagnostic local anaesthetic block supports it ## On imaging Seen with high-frequency ultrasound just above and medial to the ASIS, as two small oval structures between the internal oblique and transversus abdominis; colour Doppler shows the deep circumflex iliac artery beside them. This is the view for the ilioinguinal–iliohypogastric block. They are not seen on CT or MRI; in pain after hernia repair, imaging looks for recurrence or mesh problems. ## Clinical notes - Ilioinguinal-iliohypogastric block is used for pain after groin surgery, including hernia repair and orchidopexy in children - Pfannenstiel incision: extending it beyond the lateral edges of the rectus muscles cuts or traps the nerves, causing burning suprapubic and groin pain months later - In open hernia repair the ilioinguinal nerve lies on the cord in the canal and can be caught in sutures or mesh, so it is identified and protected - Lateral laparoscopic ports and iliac crest bone graft harvest can injure the iliohypogastric nerve and its lateral cutaneous branch ## Anatomical variants - The ilioinguinal nerve arises from L1 alone in about two-thirds of people, otherwise from T12–L1, L1–L2 or L2–L3 - The two may share a common trunk, or one may be missing, its skin territory taken over by the other or by the [genitofemoral nerve](https://durgical.com/en/anatomy/genitofemoral-nerve/) ## Related conditions - [Inguinal hernia](https://durgical.com/en/conditions/inguinal-hernia/) - [Kidney stones (urolithiasis)](https://durgical.com/en/conditions/kidney-stones/) ## Test yourself Think of the answer, then tap the question to see it. ## Between which muscles do the iliohypogastric and ilioinguinal nerves run above the iliac crest? Between transversus abdominis and the internal oblique; near the ASIS this plane is used for the ultrasound-guided block. ## How does the ilioinguinal nerve enter and leave the inguinal canal? It enters from the side, not through the deep ring, and leaves through the superficial ring in front of the spermatic cord or round ligament. ## Which operations most often injure the iliohypogastric and ilioinguinal nerves? Open inguinal hernia repair and Pfannenstiel incisions extended beyond the rectus edges, causing chronic groin pain or numbness. [Add to my cards (3)](https://durgical.app/estudiar/?add=/en/anatomy/iliohypogastric-nerve/) Educational information, not medical advice. For any symptom, see a health professional. ## Its names **Official Latin (TA2)** nervus iliohypogastricus; nervus ilioinguinalis TA2 6496 **Official Spanish (DeCS)** Nervios iliohipogástrico e ilioinguinal **English (TA2)** Iliohypogastric and ilioinguinal nerves **Also called** nervus iliopubicus · iliopubic nerve ## Related - [Transversus abdominis](https://durgical.com/en/anatomy/transversus-abdominis-muscle/) - [Internal oblique](https://durgical.com/en/anatomy/internal-abdominal-oblique-muscle/) Sources: Terminologia Anatomica (TA2); [Anatomy, Abdomen and Pelvis, Posterior Abdominal Wall Nerves](https://www.ncbi.nlm.nih.gov/books/NBK557605/). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/anatomy/iliohypogastric-nerve/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/anatomy/iliohypogastric-nerve/