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Left Indirect Inguinal Hernioplasty

Liborio "Jun" Soledad, MD; Enrico Jayma, MD
World Surgical Foundation

Abstract

The expression “inguinal hernia” refers to protrusion (or herniation) of abdominal contents through a weak spot in the abdominal wall in the region of the inguinal ligament. Inguinal hernias are 10 times more common in males than in females. Other risk factors include family history, premature birth, overweight or obesity, pregnancy, chronic cough and constipation. There are two types of inguinal hernia: indirect and direct. An indirect inguinal hernia, the more common type, often occurs in premature infants born prior to closure of the inguinal canal; however, it can occur at any age. Direct inguinal hernias occur in adults with a frequency that increases with age. They are believed to be caused by weakening of the abdominal wall musculature over time. Some individuals with inguinal hernias experience heaviness or pressure in the groin, while others feel pain or discomfort especially when bending, coughing or lifting. An inguinal hernia is usually diagnosed clinically by physical examination. However, if the diagnosis is in doubt, ultrasound, CT or MRI may be needed. Small and asymptomatic inguinal hernias may be managed expectantly, while large and symptomatic inguinal hernias require surgical repair. Inguinal hernia repair is performed by returning the protruding intestinal contents to the abdominal cavity and reinforcing the weakened abdominal wall with a synthetic mesh. Here, we present a 58-year-old male with a left indirect inguinal hernia. He presented with bulge in the left inguinal area that extended into the scrotum. Intra-operatively, we found that his sigmoid colon had herniated into the scrotal sac.

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