Scrotal Reconstruction for Giant Inguinal Hernias

Hodgkinson, Darryl; McIlrath, Donald C.

doi:10.1016/s0039-6109(16)43287-1

Cited by 104 publications

(78 citation statements)

References 5 publications

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“…1 These massive hernias are usually the result of neglect and fear of any surgical procedure and are more common in the rural population, affecting the quality of life adversely. 2 These patients generally have voiding difficulty and urinary retention, 4 and can develop pressure sores along the medial aspect of the scrotum 4,5 as well as infection and reduced mobility 4 apart from the usual complications of hernias.…”

Section: Discussionmentioning

confidence: 99%

“…Excision of the redundant scrotal skin and hypertrophic dartos muscle and construction of a neoscrotum at the time of the hernia repair have been described in other similar reports. 1,16 However, some authors claim the redundant scrotal skin should be preserved so that bowel can be temporarily returned to the scrotum in case of respiratory compromise. 5 Although this approach seems to be reasonable, 2 separate surgical procedures are needed and potential complication in the form of serious scrotal hematoma or massive lymphedema is possible.…”

Section: Discussionmentioning

confidence: 99%

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Giant Inguinoscrotal Hernia—Report of a Rare Case With Literature Review

Karthikeyan

Sistla

Ram

et al. 2014

International Surgery

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Massive inguinoscrotal hernias extending below the midpoint of the inner thigh, in the standing position constitute giant inguinoscrotal hernias. We report a patient who presented with giant right inguinal hernia with bilateral hydrocele for 25 years. He had no cardiorespiratory illnesses. He was taken up for surgery under general anesthesia after preoperative respiratory exercises. Sliding hernia with entire greater omentum, small bowel, and appendix as contents was identified. Meshplasty after omentectomy with bilateral subtotal excision of sac, right orchidectomy, and scrotoplasty were done. Giant inguinoscrotal hernias pose significant problems while replacing bowel contents because of the increase in intraabdominal and intrathoracic pressures. Recurrence is another complication seen after successful surgical management. Various techniques such as preoperative pneumoperitoneum, debulking abdominal contents with extensive bowel resections, or omentectomy and phrenectomy have been tried. Postoperative elective ventilation is also needed in many cases. We describe simple reduction with omentectomy as a viable technique in this patient. He did not need elective ventilation due to preoperative respiratory exercises and preparation and review of the literature.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Giant Inguinoscrotal Hernia—Report of a Rare Case With Literature Review

Karthikeyan

Sistla

Ram

et al. 2014

International Surgery

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“…It is defined as inguinal hernia extending till mid thigh or below in the standing position [1]. Penis is usually buried inside the scrotum causing dribbling of urine over an already edematous scrotal skin (lymphatic and venous oedema) leading to excoriation, ulceration and secondary infection.…”

Section: Discussionmentioning

confidence: 99%

Giant Inguinoscrotal Hernia Repaired by Lichtensteins Technique Without Loss of Domain -A Case Report

Shreyas

2014

JCDR

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“…Giant inguinoscrotal hernias are defined as those that extend below the midpoint of the medial thigh in the standing position [1]. These hernias are rare in the developed world and are generally seen in clinical practice after years or even decades of self-neglect [2].…”

Section: Discussionmentioning

confidence: 99%

Giant inguinoscrotal hernia: An emergency presentation with life-threatening sepsis

Burke¹,

Joyce²,

Ahmed³

et al. 2014

IJCRI

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A 74-year-old male was brought by ambulance to the emergency department with a 12-hour history of an acutely painful scrotum with associated rapidly progressing discoloration of the overlying scrotal skin. This was on a background of a giant inguinoscrotal hernia present for approximately 12 years for which he had previously declined operative intervention. Other than well controlled hypertension, his past medical was unremarkable. Upon arrival in the emergency department, he was noted as being markedly hypotensive and displaying clinical signs consistent with septic shock. His scrotum was noted as being grossly enlarged with a black discoloration (Figure 1). Several fluids filled bullae were noted on the scrotal skin ( Figure 2). On physical examination his abdomen was soft and non-tender. Initial resuscitation was provided in accordance with ATLS and sepsis guidelines. Anesthetic input was sought and the patient was transferred to the intensive care unit for continued resuscitation in the form of central venous pressure monitoring and inotropic support prior to emergency operative intervention. The patient's condition was deemed too unstable for transfer to the radiology department for preoperative imaging.In theatre, initial incision of the scrotum and examination of the scrotal contents revealed necrotic loops of small and large bowel. Mesenteric thickening was noted at the neck of the hernia sac. In light of this, a midline laparotomy incision was made and the necrotic hernial contents were reduced into the abdominal cavity

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Scrotal Reconstruction for Giant Inguinal Hernias

Cited by 104 publications

References 5 publications

Giant Inguinoscrotal Hernia—Report of a Rare Case With Literature Review

Giant Inguinoscrotal Hernia—Report of a Rare Case With Literature Review

Giant Inguinoscrotal Hernia Repaired by Lichtensteins Technique Without Loss of Domain -A Case Report

Giant inguinoscrotal hernia: An emergency presentation with life-threatening sepsis

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