Postoperative inguinal neuralgia is a known complication of open or laparoscopic herniorrhaphy, initially managed conservatively with analgesics. If symptoms do not resolve additional treatment modalities include nerve blocks, mesh explanation, neurectomy or radiofrequency ablation. Radiofrequency ablation is also used for ablation of hepatic tumors, and thermal injury to bowel is a known and well-documented complication with its use on the liver. There is no published literature or case reports describing thermal injury to bowel from radiofrequency ablation of ilioinguinal or iliohypogastric nerves. We present a case of a 44-year-old male with postoperative inguinal neuralgia following bilateral herniorrhaphies. He failed conservative management and underwent hot radiofrequency ablation of bilateral ilioinguinal and iliohypogastric nerves and presented with delayed small bowel perforation due to thermal injury.
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