Enigmatic images: inguinal hernia of a ‘third kind,’ pantaloon hernia, ‘direct pantaloon’ hernia, or direct hernia and supravesical hernia?

Hernia ◽  
2010 ◽  
Vol 14 (3) ◽  
pp. 333-334 ◽  
Author(s):  
P. Mirilas ◽  
V. Mouravas
Keyword(s):  
Inguinal Hernia ◽  
Direct Hernia

INGUINAL HERNIA REPAIR BY THE “MESH PLUG” TECHNIQUE

2014 ◽  
pp. 40-46
Author(s):  
Doan Van Phu Nguyen ◽  
Loc Le ◽  
Van Lieu Nguyen
Keyword(s):  
Inguinal Hernia ◽  
Postoperative Pain ◽  
Operating Time ◽  
Life Assessment ◽  
Medium Size ◽  
Mesh Plug ◽  
Indirect Hernia ◽  
Postoperative Rehabilitation ◽  
Early Return ◽  
Direct Hernia

Background:In 1989, Lichtenstein I. L., Shulman A. G., Amid P. K., and Montlor M. M. presented an idea of using Mesh Plug to repair the defect inguinal canal. The new technique quickly became accepted by surgeons all over the world for several reasons: faster overall rehabilitation, less postoperative pain, less complication, shorter stay in the hospital and early return to normal activities and work. Materials and method:From December 2011 to October 2012, 97 patients with inguinal hernia were surgically treated with 110 Mesh Plugs applied at the Surgery Unit of Hue University of Medicine and Pharmacy. Result:The patients’ mean age was 48.96±23.19. There were 60 patients over 40 years old, accounting for 61.9%, and 93 of the group were males, accounting for 95.8%. 24 cases were direct hernia, accounting for 21.8%, 86 cases were indirect hernia accounting for 78.2% and 11cases were direct hernia associated with indirect hernia. Based on Nyhus’s classification, there were 76 cases of IIIA and IIIB (69.1%). Based on the position of protrusion, there were 66 cases of right inguinal hernia (60.0%), 44 cases of left inguinal hernia (40.0%), and 13 cases of hernia on both sides. The average size of the deep ring is 2.19±1.54cm. 65 cases used Mesh Plug of medium size (59.1%). The mean operating time was 37.26 minutes. The time of staying in the hospital was 3.58±1.17 days. Quality of life assessment after the surgery showed 93 very good and good cases 95.8% and 4 cases (4.2%) with satisfactory result. No case of bad outcome was recorded. Conclusion: Surgical treatment of inguinal hernia by the Mesh Plug technique is really effective, safe with faster postoperative rehabilitation, less postoperative pain, less complications, shorter hospital stay and early return to normal activities and work. Key words: Inguinal hernia, Mesh Plug.

A rare encounter of obstructed direct inguinal hernia

2019 ◽  
Vol 22 (2) ◽  
pp. 41-43
Author(s):  
Amit Kumar Singh ◽  
Nripesh Rajbhandari ◽  
Balaram Malla ◽  
Gakul Bhatta
Keyword(s):  
Emergency Department ◽  
Inguinal Hernia ◽  
Intestinal Obstruction ◽  
Intestinal Resection ◽  
Posterior Wall ◽  
Acute Intestinal Obstruction ◽  
University Hospital ◽  
Direct Inguinal Hernia ◽  
Direct Hernia ◽  
The Right

The direct inguinal hernia has a wider neck and thus usually doesn’t present as strangulation or incarceration in comparison to the indirect component. When direct inguinal hernias are untreated for a longer duration, they may get strangulated and incarcerated. Hence such long-standing direct hernias with features of intestinal obstruction and /or peritonism should be promptly seen and diagnosed to prevent massive and unwanted intestinal resection. We are reporting a case of 83-year-old male presented to Surgical Emergency Department of Dhulikhel Hospital, Kathmandu University hospital with complaints of swelling in the right inguinoscrotal region for 12 years and progressed to become irreducible and painful for 12 hours. Clinically he had an acute intestinal obstruction. Intra-operatively we found a direct hernia containing congested small bowel loops and toxic fluids. The toxic fluid was suctioned and after confirming viability, modified Bassini’s repair was done with reinforcement of the posterior wall. Even direct inguinal hernia of longer duration can cause acute or sub-acute intestinal obstruction with or without features of peritonism. This complication is more common in elderly patients.

scholarly journals Strangulated direct inguinal hernia with intraperitoneal perforation

2017 ◽  
Vol 4 (12) ◽  
pp. 4093 ◽  
Author(s):  
Md Asjad Karim Bakhteyar ◽  
Binod Kumar ◽  
Sushil Kumar
Keyword(s):  
Small Intestine ◽  
Inguinal Hernia ◽  
Posterior Wall ◽  
Indirect Inguinal Hernia ◽  
Direct Inguinal Hernia ◽  
Peritoneal Perforation ◽  
Direct Hernia

Usually direct inguinal hernia doesn’t present as strangulation or incarceration as compared to indirect inguinal hernia because of earlier has wider neck. A patient of recurrent direct inguinal hernia presents as intra-scrotal gangrene and intra-peritoneal perforation. We reported a case of 65 years old male presented with septicemia and right sided strangulated direct hernia. On exploration through inguino scrotal incision and mid line laparotomy, gangrenous loop was found in scrotum and perforation was found in intra-peritoneal part of small intestine. Resection-anastomosis was done for both the parts of intestine. Inguinal Incision was closed by posterior wall closure and modified Bassini’s herniorraphy. Abdomen was closed in layers with brain. Long standing direct hernia may present as strangulation or incarceration specially in elderly but perforation and gangrene of intra-peritoneal part of small intestine is very rare.

scholarly journals PROFILE OF THE PATIENTS WHO UNDERWENT PROLENE HERNIA SYSTEM EXTENDED FOR INGUINAL HERNIA IN A TEACHING INSTITUTE IN SUBHIMALAYAN REGION

2020 ◽  
pp. 1-2
Author(s):  
Rohit Kumar ◽  
Arvind Bhatia ◽  
Shelja Rawat ◽  
Ritu Rawat ◽  
Shikha Rawat ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Surgical Repair ◽  
Previous History ◽  
Controlled Study ◽  
History Of Surgery ◽  
Indirect Hernia ◽  
Prolene Hernia System ◽  
Direct Hernia ◽  
History Of ◽  
Scrotal Swelling

Introduction: Worldwide, inguinal hernia repair is probably the most commonly performed general surgical procedure. Hence, a slight refinement of surgical repair of inguinal hernia would mean a substantial benefit to the patient. Aim: The study aimed to study profile of the patients who underwent Prolene Hernia System Extended (PHSE) for Inguinal Hernia in a teaching institute in Sub-Himalayan region. Materials and Methods: This was a controlled study conducted over 30 adult patients of both genders admitted at Dr RPGMC Tanda at Kangra from September 2016 to September 2017. Patients clinically diagnosed with inguinal hernias both direct and indirect on examination were enrolled in the trial after their informed consent. Results: Mean age of the patients was 54.9±13.66 years (range 30 to 80 years). 33% of the patients were elderly. All the patients were males. 43% of the patients were smokers and 53% were consuming alcohol. 20% of the patients had associated co-morbidities. 7% patients had previous history of surgery. Fifty percent of the patients had direct hernia while 33% had indirect hernia. Among 10% patients, it was bubonocele type. Seven patients had complications. Scrotal swelling was the most common welling (n=3) followed by inguinodynia (n=2), and seroma formation and urinary retention in one patient each. Conclusion: PHSE for management of inguinal hernia is associated with better outcomes.

scholarly journals Incarcerated Appendix Epiploica in Inguinal Hernia Sac: Treatment with Laparoscopic TAPP Approach—Report of a Rare Case

2020 ◽  
Vol 2020 ◽  
pp. 1-3
Author(s):  
Abdullah Yildiz
Keyword(s):  
Emergency Department ◽  
Inguinal Hernia ◽  
Sigmoid Colon ◽  
Rare Case ◽  
Internal Inguinal Ring ◽  
Hernia Sac ◽  
Incarcerated Inguinal Hernia ◽  
Transabdominal Preperitoneal ◽  
Direct Hernia ◽  
Mesh Hernioplasty

Appendix epiploica (AE) in an incarcerated inguinal hernia sac is very rare. We herein report the case of a 57-year-old man admitted to the emergency department with complaints of nausea, swelling, and pain in the left inguinal area. He was diagnosed with left incarcerated inguinal hernia and treated laparoscopically with transabdominal preperitoneal (TAPP) mesh hernioplasty. During the operation, AE, lodged in the direct hernia sac, was seen to originate from the sigmoid colon. The narrow internal inguinal ring was incised at the 2 o’clock position using a monopolar hook, and the hypertrophic AE was reduced to the abdomen and resected. The patient was discharged uneventfully on the second postoperative day.

scholarly journals Two mesh technique in lieu of single mesh in giant prosthetic reinforcement of the visceral sac for bilateral inguinal hernias

2017 ◽  
Vol 4 (8) ◽  
pp. 2736
Author(s):  
Bhavinder K. Arora ◽  
Rachit Arora ◽  
Akshit Arora
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Operative Time ◽  
Posterior Wall ◽  
Polyglycolic Acid ◽  
Bilateral Inguinal Hernia ◽  
Hernia Sac ◽  
Tension Free ◽  
Direct Hernia

Background: Posterior wall strengthening is the essential aim of Bilateral Inguinal hernia repair. The two methods for it are tissue repair and tension free repair. Tension free repair have become the gold standard. The preperitoneal repair for Bilateral Inguinal hernia is performed by wrapping the lower part of the parietal peritoneum with a large chevron shape polypropylene mesh.Methods: This study presents a modification of stoppas repair using a polypropylene mesh of size 15×9 cm to cover the myopectineal ostium of fruchaud on each side. The direct hernia sac was inverted with a purse string suture. Indirect hernia was opened and margins approximated with a 2-0 polyglycolic acid suture. No drainage was used.Results: Post-operative period was uneventful in all the patients. This new technique uses less post-operative time and the cost of surgery is reduced. There was one post-operative recurrence on one side only on follow up at one week, three weeks and three months.Conclusions: The use of two small size mesh covering both Fruchaud’s myopectineal orifices for bilateral inguinal hernia repair instead of a large size mesh is a promising technique. It saves the operative time and shortens the hospitalization time.

scholarly journals Late-Onset Bowel Strangulation due to Reduction En Masse of Inguinal Hernia

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Ikuo Watanobe ◽  
Noritoshi Yoshida ◽  
Shin Watanabe ◽  
Toshirou Maruyama ◽  
Atsushi Ihara ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Late Onset ◽  
Daily Practice ◽  
Indirect Hernia ◽  
Incarcerated Hernia ◽  
Incarcerated Inguinal Hernia ◽  
Long Period ◽  
Manual Reduction ◽  
Direct Hernia ◽  
Bowel Strangulation

Incarcerated inguinal hernia is often encountered by surgeons in daily practice. Although rare, hernial reduction en masse is a potential complication of manual reduction of an incarcerated hernia. Manual reduction was performed in a case of Zollinger classification type VII (combined type) hernia in which the indirect hernia portion included an incarcerated small intestine. This procedure caused hernial reduction en masse, but this went unnoticed, and the remaining portion of the direct hernia in the inguinal region was treated surgically by the anterior approach. Because the incarcerated small bowel that had been reduced en masse was not completely obstructed, the patient’s general condition was not greatly affected, and he was able to resume eating. Twenty days after surgery, he developed sudden abdominal pain as a result of gastrointestinal perforation. When performing manual reduction of an incarcerated hernia in cases after self-reduction over a long period, the clinician should always be aware of the possibility of reduction en masse.

scholarly journals Incarcerated sigmoid large-cell neuroendocrine carcinoma in an inguinal hernia

2021 ◽  
Vol 2021 (2) ◽  
Author(s):  
Martino Gerosa ◽  
Niccolò Incarbone ◽  
Emanuele Di Fratta ◽  
Giulio Maria Mari ◽  
Angelo Guttadauro ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Histopathological Examination ◽  
Laparoscopic Approach ◽  
Large Cell ◽  
Surgical Trauma ◽  
Incarcerated Hernia ◽  
Left Groin ◽  
First Case ◽  
Direct Hernia

Abstract Large-cell neuroendocrine carcinomas (NECs) of the colon are extremely rare aggressive tumors. A 79-year-old man presented at our hospital for muco-hematic diarrhea, weight loss and incarcerated hernia in his left groin. Colonoscopy revealed sigmoid stenosis. Computed tomography confirmed an incarcerated hernia containing sigmoid mass and massive abdominal adenopathy. In absence of colonic obstruction, the patient underwent elective palliative sigmoid resection and colostomy by laparoscopic approach, and direct hernia repair through inguinal access. Histopathological examination revealed a large cells sigmoid NEC. We report the first case of large-cell neuroendocrine colon cancer incarcerated in an inguinal hernia. Due to the advanced stage, we have performed a palliative laparoscopic resection in order to reduce surgical trauma, confirm pre-operative results and minimize post-operative complications, and direct hernia repair through inguinal access.

scholarly journals Anatomical variations of the inguinal morphometric features in patients with inguinal hernia and its association with the type of inguinal hernia: a prospective clinical study

2019 ◽  
Vol 6 (7) ◽  
pp. 2358
Author(s):  
Balaiya Anitha ◽  
Sathasivam Sureshkumar ◽  
Karuppusamy Aravindhan ◽  
Manwar Ali
Keyword(s):  
Inguinal Hernia ◽  
Clinical Study ◽  
Hernia Repair ◽  
Inguinal Ligament ◽  
Prospective Clinical Study ◽  
Indirect Inguinal Hernia ◽  
Transversalis Fascia ◽  
Indirect Hernia ◽  
Direct Hernia ◽  
The Mean

Background: Variations of inguinal canal and inguinal nerves are not uncommon. Knowledge about those variations is important to avoid inadvertent injury to the vital structures and to prevent recurrence.Methods: This prospective clinical study included all patients undergoing open inguinal hernia repair. Laparoscopic hernia repair, emergency surgery for complication and recurrent inguinal hernia were excluded. Parameters studied include interspinous distance, length and obliquity of inguinal ligament, attachment of conjoint tendon, condition of transversalis fascia and position and variations of ilioinguinal nerve.Results: The study included 192 patients. The mean interspinous distance (ISD) was 22±3.45 cm (CI: 30-32). ISD was not significant different among the two types of hernia. The mean length of internal oblique on inguinal ligament from anterior superior iliac spine was significantly longer in patients with indirect inguinal hernia (4±0.791 vs. 4.27±1.34; p=0.000). Significant patients in the direct hernia had weak transversalis fascia ((95% vs. 43%). 80% of the patients with direct hernia had defect in the transversalis fascia compared to only 8.8% in the indirect hernia. The difference is statistically significant. The nerve variation was present in only 1.3% in direct hernia group compared to 3.5% in the indirect hernia group.Conclusions: It was observed that the type of hernia did not significantly influenced by the length of inguinal ligament, the mean distance of midinguinal point, obliquity of the inguinal ligament. The nerve variation was present in only 1.3% in direct hernia group compared to 3.5% in the indirect hernia group.

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