Surgical management of giant inguinoscrotal hernias

Abstract

Patient underwent surgical intervention through the right inguinoscrotal approach. The sac was opened which revealed omentum, few small bowel loops and a major portion of the transverse colon (Figure 2). The entire area of the posterior wall had given way. The sac was direct in nature. The surrounding musculo-aponeurotic structures were grossly attenuated best described as almost ABSTRACT Giant Inguinoscrotal Hernias continue to pose a technical challenge to the general surgeon. Awareness of all the possible contents prior to surgery is pivotal in avoiding disastrous complications. A case of a giant inguinal hernia with transverse colon as its content is presented to highlight the diversity of contents. The natural history and surgical options for treating giant inguinoscrotal hernias is discussed. Giant inguinoscrotal hernias should be operated upon at the earliest after contrast enhanced CT evaluation for ascertaining the contents. Open surgical approach to such cases is the safest.

Giant inguinoscrotal hernia repair

“…Hernial sac may contain small and large bowel loops, greater omentum, but also urinary bladder (Ek et al, 2006, Gilleallamudi, 2010, Tahir et al, 2008, Tarchouli et al, 2015. Transverse colon, stomach and kidney along with the ureter are very rarely the content of giant inguinoscrotal hernias (Birnbaum et al, 2011, Udwadia, 1984, Vagholkar et Vagholkar, 2015, Weitzenfeld et al, 1980.…”

Hernia Inguinalis Permagna : Laporan Kasus

“…Kantung hernia dapat berisi usus halus, usus besar, omentum mayor, dan juga vesika urinaria. Lambung, ginjal, dan ureter mungkin didapatkan, tetapi biasanya jarang (Vagholkar & Vagholkar, 2015). Pada pasien hanya terdapat usus halus dalam kantung hernia.…”

Giant Inguinoscrotal Hernia

“…1 The natural history is scrotal expansion as omentum enters, followed by small bowel, colon, and possibly other organs. 2 Complications include urinary retention, leakage, infection, skin maceration, hernia incarceration, and social isolation. 1 Contrast-enhanced computed tomography followed by open surgical repair is recommended for all giant hernias.…”

“…1 Contrast-enhanced computed tomography followed by open surgical repair is recommended for all giant hernias. 2 Surgical complications from abrupt reduction of sizeable hernia contents into the peritoneal cavity include diaphragmatic dysfunction, bowel obstruction, wound dehiscence, and abdominal compartment syndrome. 1,3 Recurrence risk is elevated compared to typical inguinal hernias.…”