Unusual Manifestation of Bilateral Meralgia Paresthetica Following Laparoscopic Appendectomy: A Case Report.

Abstract

Meralgia paresthetica (MP), a mononeuropathy of the lateral femoral cutaneous nerve (LFCN), presents with dysesthesias in the anterolateral thigh. While often idiopathic, iatrogenic causes are increasingly recognized. We report a rare case of bilateral MP following laparoscopic appendectomy, highlighting its severe impact on quality of life and the need for surgical awareness. A 47-year-old male presented with persistent bilateral thigh numbness, severe pain, and allodynia after laparoscopic appendectomy. He reported significant functional limitations and sleep disturbances. Bilateral MP was diagnosed based on clinical findings and magnetic resonance imaging evidence of inflammation near the LFCN course. This case underscored the atypical presentation of bilateral MP following laparoscopic appendectomy and expands the literature on iatrogenic causes. Clinicians should include MP in the differential diagnosis of postoperative lower limb paresthesia. Surgical awareness of the LFCN vulnerability, coupled with precise trocar placement, could minimize the risk of this potentially debilitating complication.