Two Indirect Sacs in a Unilateral Inguinal Hernia, an Unusual Occurancecase Report.

Abstract

The exact type of inguinal hernia is usually made during its repair.Multiple direct or multiple indirect sacs in a unilateral inguinal hernia is extremely rare. A 30-year-old male presented with right groin swelling for six months. He was diagnosed to have right indirect inguinal hernia on clinical examination.On exploring the inguinal canal during hernial repair,two indirect sacs were found adjacent to each other,lying antero-lateral to the cord structures.Inferior epigastric artery was identified and no other direct component was found in the patient.Individual ligation of the indirect sacs was done,followed by Lichtenstein repair.This is a very rare entity,one of its kind,with only one other such case reported in India- the famous ‘Jammu Kashmir and Ladakh hernia’,a double direct,triple indirect sac in a unilateral inguinal hernia. Double indirect sac in a unilateral hernia is unique. Presence of multiple hernial sacs in inguinal hernia is a risk for recurrence, if not identified. Proper identification of inferior epigastric artery course is always essential in inguinal hernia repair.