scholarly journals Spigelian hernia with bilateral undescended (impalpable) testis in a child: rare scenario

2021 ◽  
Vol 8 (3) ◽  
pp. 578
Author(s):  
Gaurav Singh ◽  
Garvita Singh ◽  
Satish K. Aggarwal
Keyword(s):  
Inguinal Hernia ◽  
Spigelian Hernia ◽  
Acute Obstruction ◽  
Lower Abdomen ◽  
Left Testis ◽  
Impalpable Testis ◽  
External Oblique Aponeurosis ◽  
External Oblique ◽  
Internal Oblique ◽  
Conjoint Tendon

Spigelain hernia (SH) is rarely seen in children. Various mechanisms has been described for the co-existence with cryptorchidism. A 4 month old boy, a known case of bilateral impalpable testes and intermittent right lower abdominal swelling was brought to paediatric emergency with complaints of excessive cry, poor feeding and irreducible right lower abdominal swelling - the swelling was a little higher than the usual inguinal hernia. On exploration, SH was seen coming off the deep ring then turning around the conjoint tendon and dissecting between internal oblique and external oblique aponeurosis. The hernia contained oedematous but viable gut with compression over the testicular vessels. Gut was viable. The testes was mobilized and fixed into the scrotum. Left testis was impalpable for which nubbin excision was done at a later date. A SH in the lower abdomen may be confused with a high inguinal hernia. In acute obstruction, emergent exploration and reduction is the cornerstone of treatment.

scholarly journals Interparietal Inguinal Hernia with Ectopic Testis – An Uncommon Surgical Emergency

2021 ◽  
Vol 10 (12) ◽  
pp. 912-914
Author(s):  
Sunilkumar B. Alur ◽  
Sangeetha Siva
Keyword(s):  
Inguinal Hernia ◽  
Primary Anastomosis ◽  
Tubular Atrophy ◽  
Left Testis ◽  
Hernia Sac ◽  
The Past ◽  
History Of ◽  
External Oblique Aponeurosis ◽  
External Oblique ◽  
Operative Recovery

A 46-year-old gentleman presented to casualty with a reducible right groin swelling (Figure 1) present since childhood which had suddenly become painful and irreducible for the past 6 hours. He gives history of absent right testis since childhood. There’s no history of vomiting, abdominal distension or obstipation. He had no surgeries in the past, no testicular disease or infertility problems. Physical examination revealed obstructed inguinal hernia with doubtful strangulation, absent right testis and normal appearing left testis. After evaluation, patient underwent emergency exploration of right inguinal hernia under general anaesthesia which revealed gangrenous small bowel, omentum in between external oblique aponeurosis and skin without a hernia sac (Figure 2) and; ectopic right testis in the superficial inguinal pouch (Figure 3). Segmental resection of gangrenous bowel with primary anastomosis and right orchidectomy performed through the same inguinal approach. Anatomical repair of posterior wall followed by approximation of external oblique aponeurosis was performed. Histopathology report showed gangrenous ileum with patchy necrosis; testis with tubular atrophy and hyalinisation, maturation arrest of spermatogonia and hyperplasia of interstitial Leydig cells. Post-operative recovery was uneventful.

scholarly journals REPAIR OF ADULT INGUINAL HERNIA WITH CONTINUOUS SUTURES OF EXTERNAL OBLIQUE APONEUROSIS

2016 ◽  
Vol 5 (30) ◽  
pp. 1590-1595
Author(s):  
Sunilkumar Singh Salam ◽  
Jitendra N ◽  
Rosemary Vumkhoching ◽  
Renuca Karam ◽  
Arun Kumar Singh T
Keyword(s):  
Inguinal Hernia ◽  
External Oblique Aponeurosis ◽  
External Oblique

scholarly journals A New Approach to Lateral Cutaneous Nerve of Thigh Block

1986 ◽  
Vol 14 (2) ◽  
pp. 126-127 ◽  
Author(s):  
T. C. K. Brown ◽  
D. R. V. Dickens
Keyword(s):  
Cutaneous Nerve ◽  
Oblique Muscle ◽  
New Approach ◽  
Internal Oblique Muscle ◽  
Loss Of Resistance ◽  
External Oblique Aponeurosis ◽  
External Oblique ◽  
Lateral Cutaneous Nerve ◽  
Internal Oblique ◽  
Fascial Layer

A new approach to the lateral cutaneous nerve of thigh is described. It depends on locating the depth of the canal through which the nerve passes immediately medial to the anterior superior iliac spine. Anatomical dissections show that it lies deep to the attachments of external oblique aponeurosis, the internal oblique muscle, and a deep fascial layer. Two district ‘pops’ or loss of resistance can be identified during insertion of a short-bevelled needle. Location of the canal by the technique described has been confirmed radiographically.

scholarly journals Congenital inguinal hernia repair with and without opening the inguinal canal

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
A A Sabry ◽  
T A Hassan ◽  
A Allam ◽  
O K A Ali
Keyword(s):  
Inguinal Hernia ◽  
Postoperative Complications ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Inguinal Canal ◽  
External Ring ◽  
Study Results ◽  
Elective Repair ◽  
External Oblique Aponeurosis ◽  
External Oblique

Abstract Background Elective repair of congenital inguinal hernia is the most common surgery performed by pediatric surgeons and is considered the treatment of choice. The exact technique and steps involved in the repair differs widely among pediatric surgeons, many surgeons open the roof of inguinal canal while preserving the external ring or opening it, this is called the modified Ferguson, s technique. In infants, the inguinal canal is short and virtually the internal and external rings lie over each other so many surgeons also like to perform the whole operation without opening the external oblique aponeurosis distal to the external ring, this technique is called the Mitchell Banks technique. Objective To compare both techniques regarding intraoperative time, incidence of intraoperative and postoperative complications to pass our experience in a trial to reach an ideal surgical technique for congenital inguinal hernia repair. Patients and Methods In this study, 60 cases of congenital inguinal hernia were randomly selected and divided into two equal groups where group A underwent the repair with opening the external oblique aponeurosis and group B underwent the repair without opening the external oblique aponeurosis. Results As regard the postoperative complications, the patients who underwent the Ferguson’s technique experienced more postoperative pain with statistically significant more incidence of postoperative hydrocele than the Mitchell banks technique, no complications occurred postoperatively other than hydrocele in our study. Conclusion Our study results, we can approve that Mitchell Banks technique is easier, consumes less time than Ferguson’s technique with less incidence of postoperative complications and pain which can make this technique better for congenital inguinal hernia repair in children aging 2 years or less.

scholarly journals COMPARISON BETWEEN INGUINAL HERNIOTOMIES WITH AND WITHOUT INCISING EXTERNAL OBLIQUE APONEUROSIS: A RANDOMIZED CLINICAL TRIAL

2017 ◽  
Vol 30 (3) ◽  
pp. 187-189 ◽  
Author(s):  
Shahnam ASKARPOUR ◽  
Mehran PEYVASTEH ◽  
Shaghayegh SHERAFATMAND
Keyword(s):  
Clinical Trial ◽  
Inguinal Hernia ◽  
Traditional Method ◽  
Testicular Atrophy ◽  
Indirect Inguinal Hernia ◽  
Significant Difference ◽  
External Oblique Aponeurosis ◽  
External Oblique ◽  
Inguinal Herniotomy ◽  
Better Than

ABSTRACT Background: Inguinal herniotomy is the most common surgery performed by pediatric surgeons. Aim: To compare the results and complications between two conventional methods of pediatric inguinal herniotomy with and without incising external oblique aponeurosis in terms of recurrence of hernia and other complications. Methods: This one blinded clinical trial study was conducted on 800 patients with indirect inguinal hernia. Inclusion criterion was children with inguinal hernia. The first group underwent herniotomy without incising external oblique aponeurosis and second group herniotomy with incising external oblique aponeurosis. Recurrence of hernia and other complications including ileoinguinal nerve damage, hematoma, testicular atrophy, hydrocele, ischemic orchitis, and testicular ascent were evaluated. Results: Recurrence and other complications with or without incising external oblique aponeurosis had no significant difference, exception made to hydrocele significantly differed between the two groups, higher in the incision group. Conclusion: Herniotomy without incising oblique aponeurosis can be appropriate choice and better than herniotomy with incising oblique aponeurosis. Children with inguinal herniotomy can be benefit without incising oblique aponeurosis, instead of more interventional traditional method.

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