Chronic abdominal wall pain is frequently unrecognized or confused with visceral pain, often leading to extensive diagnostic testing and surgical interventions before an accurate diagnosis is achieved.

A 34 -year-old woman with chronic abdominal pain underwent an array of investigations and surgical interventions with recurrence of pain. When she was admitted to hospital because of a flare up of pain, the pain clinic service was consulted. The presentation of pain that was reproduced by eliciting focal tenderness- Tinel’s sign over the course of ilioinguinal nerve made nerve entrapment a possible diagnosis. A diagnostic ilioinguinal nerve block was performed, resulting in complete relief of the pain which was later followed by radiofrequency ablation as a therapeutic intervention was performed.

Chronic abdominal or pelvic pain due to peripheral neuropathy can mimic visceral pain, presenting a diagnostic challenge which is often missed in the clinical settings. Diagnosis by careful history, examination and nerve blocks can avoid delay in managing these potentially treatable condition.