A Case of Reduction en Masse of an Inguinal Hernia Treated by Laparoscopic Surgery

Abstract

An83-year-oldmanvisitedanotherhospitalwithabdominalpainandnausea.Basedonabdominal radiography,hewasdiagnosedwithsmallbowelobstruction,andthenreferredtoourhospitalforfurther evaluation. At our hospital, he was diagnosed with strangulated bowel obstruction based on abdominal computedtomography (CT). Emergency laparoscopic surgery was performedduring which we repositioned the incarcerated and strangulated small bowel. After bowel repositioning, we identified a direct herniaorifice,diagnosedasreductionenmasseofaninguinalhernia,andtransabdominalpreperitonealrepairwasperformed.Reductionenmasseisrare,anditisdefinedasreductionoftheherniasactogether withtheincarceratedbowelintothepreperitonealspace.Promptdiagnosisofthisconditionisessential becauseitconstitutesasurgicalemergency.