Giant Inguinoscrotal Hernia

The following article devoted to the case of surgical treatment of giant inguinoscrotal hernia of a patient which signed the informed consent to the processing of personal data with dimensions of hernial sac 400x330x306 mm, size of hernial gates 9x8x7cm, loops of the small intestine, mesentery, a large number of heterogeneous liquid up to 14.7 L were determined in the hernial sac. Left herniotomy was performed. Back wall plastic of the inguinal canal was performed according to Liechtenstein. Mesh implant was used for the plastic.

Bilateral giant inguinoscrotal hernia with hydrocele. A case report

Giant inguinoscrotal hernia (GIH) is a high morbidity and mortality disease. Giant inguinoscrotal hernia containing omentum, intestinal segments or urinary bladder is a challenging surgical disease. The patient was diagnosed with bilateral giant inguinoscrotal hernia at the age of 81. The case had 22 years history of this uncommon disease. Ultrasound revealed a voluminous hernia sac containing bowel loops, greater omentum, and hydrocele. According the new classification of GIH, the patient was type II. He underwent complete surgical hernioplasty involving omentectomy and orchiectomy. After the surgery, any emerging complications were closely monitored. When giant inguinoscrotal hernia is diagnosed, operation should be recommended immediately. Treatment procedure of hernia should be according the classification of GIH. The Lichtenstein tension-free technique seems to be the best surgical procedure for the patient who have bilateral hernia. It should be used whenever possible in such cases. The patients should be carefully follow up postoperative in terms of abdominal compartment syndrome and respiratory insufficiency.

Giant Inguinoscrotal hernia -a radiological perspective

Inguinal hernia is a common surgical disease. Giant inguinoscrotal hernias are more unusual and impose significant impact on quality of life including difficulty with mobility, scrotal skin ulceration and bowel obstruction. Besides it is more challenging in terms of surgical management. Diagnosis of giant inguinoscrotal hernia is straight forward on clinical examination. Nevertheless, with the advent of CT scan, pre-operative contrast-enhanced CT scan is useful for ascertaining the hernia contents, its configuration and measuring the neck of hernia. We report a case of a patient with extremely huge irreducible right giant inguinoscrotal hernias.

A SCROTAL ABDOMEN IN AN ELDERLY PATIENT MANAGED BY HERNIOPLASTY WITHOUT DEBULKING OF THE HERNIA CONTENTS: A CASE REPORT AND LITERATURE REVIEW

Background: Scrotal abdomen is not a common today, but most challenging case even in experienced general surgeon, as there is no standard surgical procedure. They present as a huge inguinoscrotal swelling for a longstanding, neglected to treatment, because fear of operative intervention and remote places where medical service is inadequate. The morbidity and mortality also high because of forced reduction of the herniated viscera to the abdominal cavity, which is accustomed to being relatively empty for long duration, may cause alteration in the intra-abdominal and intra-thoracic pressures, leading to complications such as ACS, precipitation of cardiovascular or respiratory compromise, hernia recurrence and wound dehiscence . We present this ca Case presentation: se of giant inguinoscrotal hernia of a 72 years old male who had difculty in performing his daily activities. Patient underwent emergency mesh repair after reduction of content through inguinal approach. Giant inguinal hernia containing almost whole abdomen with terminal 50 cm ileum, caecum, appendix, ascending colon, hepatic exure of colon and transverse colon with omentum in the hernia sac and the patient had an uneventful recovery with eventual discharge on postoperative day 8. The giant inguinal hernias are uncommon in today's surgical Conclusion: practice. Management of which is challenging with grave complications but early intervention and postoperative monitoring to raised IAP and its complications which can save the patient. We report this case of an elderly patient with an acute presentation of scrotal abdomen with contents as both direct and indirect component which has been managed successfully with tension free open mesh hernioplasty and biological repair without debulking of the hernia contents and this case supported by a review of the literature.

Giant inguinoscrotal hernia in children: two rare cases

Background Inguinal hernia is one of the most common surgical diseases encountered in adults as well as in children. Though rare, giant inguinoscrotal hernias are reported in adults, however, are rarely reported in children. Case presentation Here is a report of two rare cases of giant inguinoscrotal hernias in children managed successfully. Conclusion Giant inguinoscrotal hernias in children are rare and should be referred early and managed in a tertiary care paediatric centre.

Repair of giant inguino-scrotal hernia with loss of domain using minimally invasive anterior component separation technique combined with Lichtenstein tension-free mesh hernioplasty

Inguinal hernia repairs are most commonly performed surgical procedures across the world. Lichtenstein's tension free technique of open hernioplasty is the gold standard technique, while laparoscopic techniques gained popularity over recent decade. Giant inguinal hernias are rare. Giant inguinal hernia extends below the midpoint of the inner thigh, in the standing position. These are long standing conditions and at presentation years of herniation or even decades. We report a patient of 65 years of age presented with type-II left sided giant inguinoscrotal hernia from last 10 years with loss of domain. Contrast enhanced computed tomography (CECT) revealed, omentum and ileal loops with mesentry as contained in hernia sac, which was repaired by minimally invasive anterior component separation technique to increase the intra-abdominal volume followed by omentectomy and Lichtenstein mesh hernioplasty without any complications. He recovered uneventfully. Surgical management of giant inguinal hernia is significantly more challenging and unusual because of ‘loss of domain’ and returning herniated viscera into the empty abdominal cavity forcefully can lead to high intra-abdominal pressure, recurrence or abdominal compartment syndrome. There are several repair techniques in literatures such as resection of contents and increased intra-abdominal volume increasing procedures but there is no standard protocol or surgical procedure for the management of giant hernias. We describe a technique which is relatively simple, less expensive and less invasive used for type II unilateral giant inguinoscrotal hernia with loss of domain in patient with co-morbidities.

Successful outcome of a giant inguinoscrotal hernia: a novel two-staged repair using preoperative progressive pneumoperitoneum and transversus abdominis release

Giant inguinoscrotal hernias, defined as the extension beyond the midpoint of the inner thigh, continue to require multi-step approaches due to their complexity. Although rare in developed countries, they are commonly present in rural areas after years of neglect. This consequently allows the abdomen to maladapt to lower volumes, creating a loss of domain. Here, we present a giant left inguinoscrotal hernia managed with a unique multi-stage approach, aimed to minimize commonly encountered perioperative complications associated with abdominal hypertension. The combined two-staged approach used begins with preoperative progressive pneumoperitoneum, followed by the combined procedures of laparotomy hernia repair (Stoppa technique) and transversus abdominis release, thereby promoting a tension-free closure that is able to accommodate the reduced contents. Various modalities used in treating these hernias have been previously described; however, to our knowledge, the combined use of techniques described here has not been reported.