A Rare Presentation of Maydl’s Hernia

Abstract

We present a case of an unsual type of obstructed indirect inguinal hernia with impending strangulation. The operative findings revealed a sliding Maydl's hernia with an ischemic inner ileal loop and an adherent inflamed appendix. This case highlights the importance of intraoperative examination of the intra-abdominal bowel loops proximal to the hernia sac of an incarcerated, obstructed, or strangulated hernia.

Femoral, Direct, and Rare Inguinal Hernias in Children—An Update

“…88 Another very rare hernia type is the so-called Maydl hernia, in which the hernia sac contains two loops of intestine (strangulated intestine at lower apices of a stylistic "W"). 89,90 The loop of intestine within the abdominal cavity may become obstructed or strangulated, and this may not be recognized unless the hernia contents are promptly reduced to the abdominal cavity completely. There are only few case reports published, but unrecognized; a Maydl hernia can be lethal.…”

Appendicitis;

“…Claudius Amyand, a French surgeon, while performing Herniotomy, removed perforated appendix from hernial sac of an 11-year old boy on December 6, 1735 at St. George's Hospital in London. 1 Mr. Abraham Goves had performed first ever appendectomy in august 1883. 2 Reginald Fitz noted the appendectomy as an effective treatment of acute appendicitis.…”