Related Experiment Videos

A case of giant inguinal hernia with intestinal malrotation

Seung Eun Lee1

  • 1Department of Surgery, Chung-Ang University College of Medicine, 224-1 Heukseok-dong, Dongjak-gu, Seoul 156-755, Republic of Korea.

International Journal of Surgery Case Reports
|August 28, 2012
PubMed
Abstract

Insights

Giant inguinal hernias are rare, especially when containing malrotated intestine. This case highlights a unique surgical challenge involving a large inguinoscrotal hernia with complex intestinal malrotation, successfully managed with simultaneous procedures.

Area of Science:

  • Gastroenterology
  • Surgical Oncology
  • Abdominal Surgery

Background:

  • Giant inguinal hernias are infrequent in modern medical practice.
  • This case presents a rare instance of a massive inguinoscrotal hernia.

Purpose of the Study:

  • To report the first case of a giant inguinal hernia containing malrotated intestine.
  • To discuss the surgical management of complex giant inguinoscrotal hernias.

Main Methods:

  • A 75-year-old male patient with schizophrenia presented with a large, irreducible right inguinoscrotal hernia.
  • Laparotomy revealed extensive intestinal herniation (proximal transverse colon to terminal ileum) with malrotation.
  • The patient underwent simultaneous Ladd's procedure, appendectomy, and inguinal defect closure.

Main Results:

  • The giant inguinoscrotal hernia contained a significant portion of the small and large intestine.
  • No signs of ischemia or strangulation were observed in the herniated bowel.
  • The surgical repair was completed without complications.

Conclusions:

  • Giant inguinoscrotal hernias, particularly those with malrotation, pose unique surgical challenges.
  • There is no established standard surgical approach for these complex hernias.
  • This case underscores the importance of tailored surgical strategies for rare abdominal conditions.

Related Concept Videos

Intestinal Obstruction I: Introduction01:29

Intestinal Obstruction I: Introduction

Intestinal obstruction is a partial or complete blockage of the small or large intestine that disrupts the normal flow of intestinal contents through the lumen. This interruption impairs digestion, absorption, and fluid balance, and may lead to serious complications if not treated promptly.Mechanical ObstructionMechanical obstruction occurs when a physical blockage prevents intestinal contents from passing, arising from within the lumen or the bowel wall, or from external compression.Adhesions,...
Hiatal Hernia01:25

Hiatal Hernia

A hiatal hernia is the abnormal protrusion of the stomach or other abdominal organs through the esophageal hiatus of the diaphragm into the thoracic cavity.Normally, the gastroesophageal junction (GEJ) lies below the diaphragm and is supported by the phrenoesophageal membrane, the diaphragmatic crura, and connective tissues. Weakening of these structures—due to aging, congenital defects like a short esophagus, or increased intra-abdominal pressure from coughing, obesity, pregnancy, or heavy...
Inflammatory Bowel Disease V: Surgical Management01:21

Inflammatory Bowel Disease V: Surgical Management

Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
Here are some common surgical interventions for IBD:
Intestinal Obstruction II: Pathophysiology01:07

Intestinal Obstruction II: Pathophysiology

Intestinal obstruction triggers a series of physiological responses, starting with gas and fluid accumulation in the bowel segment proximal to the obstruction, leading to distension. This distended intestine compresses the diaphragm, hindering lung expansion and potentially leading to reduced respiratory effort, atelectasis, and pneumonia.To overcome the blockage, the gut intensifies contractions, causing colicky abdominal pain, nausea, and vomiting, which reduces fluid and food intake and...
Appendicitis01:19

Appendicitis

Appendicitis is an acute inflammatory condition of the vermiform appendix, most commonly caused by obstruction of its lumen. The appendix is a narrow, blind-ended pouch that extends from the cecum, making it particularly prone to obstruction. Causes include fecaliths, lymphoid hyperplasia (often after viral infections), parasites, tumors, or foreign bodies. This obstruction initiates a cascade of pathological changes.Luminal Obstruction and Early InflammationAfter obstruction, normal mucosal...
Diverticular Disease of the Colon01:27

Diverticular Disease of the Colon

Diverticular disease involves the formation of diverticula—small sac-like outpouchings of the colonic wall—and their complications. It most commonly affects the sigmoid colon due to higher intraluminal pressure and structural vulnerability. It results from structural weakness and increased pressure in the colon, producing pseudodiverticula that may remain silent or progress to inflammation and serious complications.Structure of DiverticulaIn diverticulosis, these outpouchings are...