Giant inguinal hernia, a case series

Inguinal hernia surgery is common worldwide. A giant inguinal hernia occurs when the hernia extends below the midpoint of the thigh, making reduction into the abdominal cavity challenging and posing significant operative and postoperative risks.

We report a case series of five male patients, aged 51-75 years, with giant inguinal hernias treated between January 2024 and January 2025. Four patients presented electively and one emergently with strangulation. All hernias extended below the midpoint of the thigh. Open surgical repair was performed in all cases, with reduction via an abdominal incision above the inguinal crease. The hernia contents included small and large bowel loops with omentum. In one case, the inferior epigastric artery was ligated to facilitate reduction.

We report a case series of five male patients, aged 51-75 years, with giant inguinal hernias treated between January 2024 and January 2025. Four patients presented electively and one emergently with strangulation. All hernias extended below the midpoint of the thigh. Open surgical repair was performed in all cases, with reduction via an abdominal incision above the inguinal crease. The hernia contents included small and large bowel loops with omentum. In one case, the inferior epigastric artery was ligated to facilitate reduction.

Giant inguinal hernias require individualized surgical planning. Careful reduction, sac excision, and reinforcement with mesh can achieve good outcomes. Ligation of the inferior epigastric artery may aid reduction in specific cases. A better understanding of socioclinical factors leading to delayed presentation may improve earlier detection and intervention.