Giant Inguinoscrotal Hernia: The Challenging Surgical Repair and Postoperative Management

Abstract

Abstract:Inguinal hernia operations are compulsory surgical skill assessment for residence in surgical field and most centres practice day care services for such cases. Giant inguinal hernias usually occur in neglected long standing diseases and repair of these condition added challenges in term of content reduction as well as managing postoperative complications. This case was a unique case of a giant inguinal hernia which was left untreated for 40 years. The contents of the hernia which include greater omentum, small and large bowel were reduced successfully after extension of the deep inguinal ring. The patient was ventilated and paralyzed for 48 hours in view of anticipating intraabdominal hypertension. Post operatively the patient recovered well and discharged on Day 6 post operatively.

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

“…The reconstruction becomes complex due to the maladaptive loss of abdominal domain which can no longer accommodate herniated contents without the increased risk of abdominal hypertension. Perioperative complications associated with an increased abdominal pressure may incite fatal cardiorespiratory failure by way of cephalad diaphragm displacement and compression of the inferior vena cava [ 4 ]. Several surgical modalities are described in the literature with varying combinations in treating GIHs [ 2 ].…”