Skip to main content

Advertisement

Log in

Challenging surgical management of a giant inguinoscrotal hernia: Report of a case

  • Case Report
  • Published:
Surgery Today Aims and scope Submit manuscript

Abstract

This report describes the surgical management of a giant inguinoscrotal hernia, which extended below the patient’s knees, causing considerable physical discomfort and impairment of his quality of life. Initial management involved improving the patient’s general condition and performing progressive preoperative pneumoperitoneum over 18 days. Surgery involved debulking the contents of the massive hernia sac by performing right hemicolectomy and transverse colectomy, repositioning of the small bowel into the abdominal cavity, resection of the giant hernia sac, and plastic reconstruction of the penis and scrotal region. The abdominal wall was reinforced with composite mesh. Despite a complicated postoperative course, the patient recovered well and has progressively returned to normal activities. Although challenging and demanding, surgery represents the only mode of treatment that can offer the patient with a giant inguinoscrotal hernia a satisfactory level of function and quality of life.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Serpell JW, Polglase AL, Anstee EJ. Giant inguinal hernia. Aust NZ J Surg 1988;58:831–834.

    Article  CAS  Google Scholar 

  2. Hodgkinson DJ, McIlrath DC. Scrotal reconstruction for giant inguinal hernias. Surg Clin North Am 1980;64:307–313.

    Google Scholar 

  3. Moss G. Techniques to aid in hernia repair complicated by the loss of domain. Surgery 1975;78:408.

    CAS  PubMed  Google Scholar 

  4. Mehendale FV, Taams KO, Kingsnorth AN. Repair of a giant inguinoscrotal hernia. Br J Plast Surg 2000;53:525–529.

    Article  Google Scholar 

  5. Ek EW, Ek ET, Bingham R, Wilson J, Mooney B, Banting SW, et al. Component separation in the repair of a giant inguinoscrotal hernia. Aust NZ J Surg 2006;76:950–952.

    Article  Google Scholar 

  6. Sturniolo G, Tonante A, Gagliano E, Taranto F, Lo Schiavo MG, D’Alia C. Surgical treatment of the giant inguinal hernia. Hernia 1999;3:27–30.

    Article  Google Scholar 

  7. Udwadia TE. Stomach strangulated in inguinal hernia presenting with hematemesis. Int Surg 1984;69:177–179.

    CAS  PubMed  Google Scholar 

  8. Weitzenfeld MB, Brown BT, Morillo G, Block NL. Scrotal kidney and ureter: an unusual hernia. J Urol 1980;123:437–438.

    CAS  PubMed  Google Scholar 

  9. Merrett ND, Waterworth MW, Green MF. Repair of giant inguinoscrotal inguinal hernia using marlex mesh and scrotal skin flaps. Aust NZ J Surg 1994;64:380–383.

    Article  CAS  Google Scholar 

  10. Forrest J. Repair of massive inguinal hernia. Arch Surg 1979;114: 1087–1088.

    CAS  PubMed  Google Scholar 

  11. Kyle SM, Lovie MJ, Dowle CS. Massive inguinal hernia. Br J Hosp Med 1990;43:383–384.

    CAS  PubMed  Google Scholar 

  12. Barst HH. Pneumoperitoneum as an aid in the surgical treatment of giant herniae. Br J Surg 1972;59:360–364.

    Article  CAS  PubMed  Google Scholar 

  13. Stoppa RE. The treatment of complicated groin and incisional hernias. World J Surg 1989;13:545–554.

    Article  CAS  PubMed  Google Scholar 

  14. Willis S, Schumpelick V. Use of progressive pneumoperitoneum in the repair of giant herniae. Hernia 2000;4:105–111.

    Article  Google Scholar 

  15. El-Dessouki NI. Preperitoneal mesh hernioplasty in giant inguinoscrotal hernias: a new technique with dual benefit in repair and abdominal rooming. Hernia 2002;5:177–181.

    Google Scholar 

  16. Mathes SJ, Steinwald PM, Foster RD, Hoffman WY, Anthony JP. Complex abdominal wall reconstruction: a comparison of flap and mesh closure. Ann Surg 2000;4:586–596.

    Article  Google Scholar 

  17. El Saadi AS, Al Wadan AH, Hamerna S. Approach to a giant inguinoscrotal hernia. Hernia 2005;9:277–279.

    Article  PubMed  Google Scholar 

  18. Hayami S, Hotta T, Takifuji K, Iwahashi M, Mitani Y, Yamaue H. Reconstruction of an infected recurrent ventral hernia after a mesh repair using a pedicled tensor fascia lata flap: report of two cases. Surg Today 2009;39:811–817.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Additional information

K. Vasiliadis and H.-P. Knaebel contributed equally to this study.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Vasiliadis, K., Knaebel, HP., Djakovic, N. et al. Challenging surgical management of a giant inguinoscrotal hernia: Report of a case. Surg Today 40, 684–687 (2010). https://doi.org/10.1007/s00595-009-4125-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00595-009-4125-3

Key words

Navigation