A rare encounter of obstructed direct inguinal hernia of sliding variety

Abstract

HighlightsObstructed direct inguinal hernia of sliding variety with bladder being one of its contents is extremely rare and no such case has been reported yet.Though incarceration and even strangulation are extremely uncommon in direct inguinal hernia as compared to indirect inguinal hernia. A long standing direct inguinal hernia may present as acute or sub-acute intestinal obstruction especially in elderly patients. Hence old age with obstructed inguinal hernia might be of direct variety and needs to be repaired immediately.Sliding hernias are diagnosed intra-operatively and is very difficult to identify clinically. Sliding hernias are most common in old age male, of indirect variety on left side according to most literatures.The good operating technique and the use of modern prosthetic materials should allow us to have the same risk of early and late complications after operating on a sliding and non-sliding inguinal hernia.

A Rare Case of a Direct Incarcerated Inguinal Hernia Containing an Epiploic Appendage and a Literature Review

“…5 Nevertheless, an increased risk has been strongly associated with indirect hernias, whereas the less prevalent direct hernias, are about three times less likely to become complicated which can be attributed to their wider neck. 4,8,9 Specifically, indirect hernias herniate through the internal inguinal ring, which has narrow diameter, while direct hernias protrude through Hesselbach's triangle, medial to the inferior epigastric vessels. 10 However, despite the fact, that the neck of the fascial defect in direct hernias is initially wide and soft, studies have shown that it can become fibrotic and inelastic over time, and the above may multiply the risk of incarceration.…”

The relationship between glycine levels in collagen in the anterior rectus sheath tissue and the onset of indirect inguinal hernia: A cross-sectional study

“…Inguinal hernias are generally classified as direct, indirect, or femoral based upon the site of herniation relative to surrounding structures [ [18] , [19] , [20] ]. The study population consisted of all the patients who were treated for indirect inguinal hernia at our institution.…”

Rare course of the ureter

“…Sliding inguinal hernias involve the protrusion of retroperitoneal structures via the inguinal canal. There are three types of sliding hernias, those with a hernia sac comprising of: type 1, viscus wall; type 2, retroperitoneal viscus and mesentery; and type 3, viscus itself without the peritoneal sac 1 …”

“…There are three types of sliding hernias, those with a hernia sac comprising of: type 1, viscus wall; type 2, retroperitoneal viscus and mesentery; and type 3, viscus itself without the peritoneal sac. 1 Ureteral herniation is a rare phenomenon involving the protrusion of the ureter and retroperitoneal fat within the inguinal canal, ANZJSurg.com incidentally diagnosed during herniorrhaphy or post-operatively in the setting of acute renal failure. When encountered, it occurs in two anatomical variants: para-peritoneal (with a peritoneal sac) or extra-peritoneal (without a peritoneal sac).…”