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. 2014;5(11):868-72.
doi: 10.1016/j.ijscr.2014.10.042. Epub 2014 Oct 18.

Giant inguinal hernia: Report of a case and reviews of surgical techniques

Atthaphorn Trakarnsagna  1 , Vitoon Chinswangwatanakul  1 , Asada Methasate  1 , Jirawat Swangsri  1 , Chainarong Phalanusitthepha  1 , Thammawat Parakonthun  1 , Voraboot Taweerutchana  1 , Thawatchai Akaraviputh  2
Affiliations

Giant inguinal hernia: Report of a case and reviews of surgical techniques

Atthaphorn Trakarnsagna et al. Int J Surg Case Rep. 2014.

Abstract

Introduction: Inguinal hernia is one of the most surgical common diseases. Giant inguinal hernia is more unusual and significantly challenging in terms of surgical management. It is defined as an inguinal hernia that extends below the midpoint of inner thigh when the patient is in standing position.

Presentation of case: A 67-year-old male presented with giant right-side inguinal hernia with symptoms of partial colonic obstruction and significant weight loss. Barium enema revealed ascending colon, cecum and ileum contained in hernia sac without significant lesions of large bowel. He underwent hernia repair with omentectomy. Hernioplasty with polypropylene mesh was performed without any complications. He recovered uneventfully.

Discussion: There were several repair techniques suggested by published articles such as resection of the content and increased intraabdominal volume procedure. Many key factors for management of the giant inquinal hernia were discussed. A new classification of the giant inquinal hernia was described.

Conclusion: Surgical repair for the giant inquinal hernia is challenging and correlated with significant morbidity and mortality due to increased intra-abdominal pressure.

Keywords: Giant inguinal hernia; Hernioplasty; Treatment.

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Figures

Fig. 1
Fig. 1
The hernia sac extended to level of lower thigh. The patient was on supine position.
Fig. 2
Fig. 2
Barium enema revealed ascending colon, cecum and ileum containing in the hernia sac without significant lesions of the large bowel.
Fig. 3
Fig. 3
Intraoperative findings: the huge hernia sac (H) was separated from right testis (T) (A). Terminal ileum, cecum, ascending colon and omentum were found as the contents of the hernia sac (B).
Fig. 4
Fig. 4
New classification of giant inguinal hernia and recommended procedure.
See this image and copyright information in PMC

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