Advertisement

Hernia

, Volume 10, Issue 2, pp 152–155 | Cite as

Uncommon content in groin hernia sac

  • A. Gurer
  • M. Ozdogan
  • N. Ozlem
  • A. Yildirim
  • H. Kulacoglu
  • R. Aydin
Original Article

Abstract

Groin hernia may have very unusual sac content. Vermiform appendix, acute appendicitis, ovary, fallopian tube and urinary bladder have been rarely reported. We aimed to present our experience with these unusual hernia contents. Records of 1,950 groin hernia patients were retrospectively analyzed. Vermiform appendix was found in 0.51% and acute appendicitis was found in 0.10% of groin hernia sacs. The incidence of appendix in femoral hernia was 5%, while inguinal hernia sac contained ovary and fallopian tube in 2.9% of the cases. The incidence of groin hernias containing urinary bladder was 0.36%. We also had 1 patient with incarcerated bladder diverticula in an indirect hernia sac. Iatrogenic bladder injury occurred in 2 patients. Although rare, a groin hernia sac may contain vermiform appendix and exceptionally acute appendicitis. Tubal and ovarian herniation in inguinal hernias can be found in adult and perimenopausal women with an incidence as high as in children. Urinary bladder hernia occurs with a similar incidence of tuba-ovarian hernia, however, it requires special attention because of a high risk of iatrogenic bladder injury during the inguinal dissection. Every effort should be made to preserve the organ found in hernia sac for an uneventful postoperative period.

Keywords

Hernia Inguinal Femoral Ovary Bladder Sac content 

References

  1. 1.
    Gibbons CER, Malhotra AK, Harvey MH (1994) Inguinal hernia: an unusual cause of gastric outlet obstruction. Br J Hosp Med 52:360–361PubMedGoogle Scholar
  2. 2.
    Oruc MT, Kulah B, Saylam B, Moran M, Albayrak L, Coskun F (2002) An unusual presentation of metastatic gastric cancer found during inguinal hernia repair: case report and review of the literature. Hernia 6:88–90CrossRefPubMedGoogle Scholar
  3. 3.
    D’Alia C, Lo Schiavo MG, Tonante A, Taranto F, Gagliano E, Bonanno L, Di Giuseppe G, Pagano D, Sturniolo G (2003) Amyand’s hernia: case report and review of the literature. Hernia 7:89–91CrossRefPubMedGoogle Scholar
  4. 4.
    Thomas WEG, Vowles KDJ, Williamson RCN (1982) Appendicitis in external herniae. Ann R Coll Surg Engl 64:121–122PubMedGoogle Scholar
  5. 5.
    Montes IS, Deysine M (2003) Spigelian and other uncommon hernia repairs. Surg Clin N Am 83:1235–1253CrossRefPubMedGoogle Scholar
  6. 6.
    Doig CM (1970) Appendicitis in umbilical hernia sac. Br Med J 2:113–114PubMedGoogle Scholar
  7. 7.
    Archampong EQ (1969) Strangulated obturator hernia with acute gangrenous appendicitis. Br Med J 1:230PubMedCrossRefGoogle Scholar
  8. 8.
    Carey LC (1967) Acute appendicitis occurring in hernias: a report of 10 cases. Surgery 61:236–238PubMedGoogle Scholar
  9. 9.
    Nguyen ET, Komenaka IK (2004) Strangulated femoral hernia containing a perforated appendix. Can J Surg 47:68–69PubMedGoogle Scholar
  10. 10.
    Voitk AJ, Macfarlane JK, Estrada RL (1974) Ruptured appendicitis in femoral hernias. Ann Surg 179:24–26PubMedCrossRefGoogle Scholar
  11. 11.
    Lester R, Bourk JB (1979) Strangulated femoral herniae containing appendices. J R Coll Surg Edinb 24:102–103PubMedGoogle Scholar
  12. 12.
    Gerami S, Easley GW, Mendosa CB (1970) Appendiceal abscess as contents of right femoral hernia. Int Surg 53:354–356PubMedGoogle Scholar
  13. 13.
    Zissin R, Brautbar O, Shapiro-Feinberg M (2000) CT diagnosis of acute appendicitis in a femoral hernia. Br J Radiol 73: 1013–1014PubMedGoogle Scholar
  14. 14.
    Ryan WJ (1937) Hernia of the vermiform appendix. Ann Surg 106:135CrossRefGoogle Scholar
  15. 15.
    Roth CG, Varma JD, Tello R (1999) Gastrointestinal/genitourinary case of the day. Incarcerated inguinal hernia of the left fallopian tube and ovary. AJR Am J Roentgenol 173:787, 791–792Google Scholar
  16. 16.
    Bradshaw KD, Carr BR (1986) Ovarian and tubal inguinal hernia. Obstet Gynecol 68(Suppl 3):50S–52SPubMedGoogle Scholar
  17. 17.
    Gnidec AA, Marshall DG (1986) Incarcerated direct inguinal hernia containing uterus, both ovaries and fallopian tubes. J Pediatr Surg 21:986PubMedCrossRefGoogle Scholar
  18. 18.
    Messmore IL, Beecham CT (1969) Bilateral adnexial hernia in an infant. Am J Obstet Gynecol 103:593–595PubMedGoogle Scholar
  19. 19.
    Amarin ZO, Hart DM (1988) Inguinal ovary and fallopian tube—an unusual hernia. Int J Gynaecol Obstet 27:141–143CrossRefPubMedGoogle Scholar
  20. 20.
    Oruc MT, Akbulut Z, Ozozan O, Coskun F (2004) Urological findings in inguinal hernias: a case report and review of the literature. Hernia 8:76–79CrossRefPubMedGoogle Scholar
  21. 21.
    Gomella LG, Spires SM, Burton JM, Ram MD, Flanigan RC (1985) The surgical implications of herniation of the urinary bladder. Arch Surg 120:964–968PubMedGoogle Scholar
  22. 22.
    Pasquale MD, Shabahang M, Evans SRT (1993) Obstructive uropathy secondary to massive inguinoscrotal bladder herniation. J Urology 150:1906–1908Google Scholar

Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  • A. Gurer
    • 1
  • M. Ozdogan
    • 1
  • N. Ozlem
    • 1
  • A. Yildirim
    • 1
  • H. Kulacoglu
    • 1
    • 2
  • R. Aydin
    • 1
  1. 1.Department of General SurgeryAtaturk Teaching and Research HospitalAnkaraTurkey
  2. 2.AnkaraTurkey

Personalised recommendations