[Peri-inguinal strangulated hernia: report of a case].

Dipartimento di Chirurgia P.Valdoni, Università degli Studi di Roma La Sapienza, Italy.
Il Giornale di chirurgia 05/2007; 28(4):142-4.
Source: PubMed

ABSTRACT Peri-inguinal hernias are rare defects of ventral lateral abdominal wall, just above the inguinal region. These hernias are due to congenital defects of internal oblique and transverse muscles. Since their rarity and the complex anatomy of the region, their correct classification is still debated. It is possible to make diagnosis by clinical examination; imaging can help the physician to recognize this rare pathology. The Authors describe a case of strangulated peri-inguinal hernia, that required urgent surgery.

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    ABSTRACT: Atypical hernias are difficult to diagnose due to their rarity and often unspecific symptoms. In the literature there exist hints to peri-inguinal hernias, i.e. direct lateral hernia, but most of them are forms of Spigelian hernias. Since the majority were described during the first half of the past century or even earlier, only very few cases have been documented using modern diagnostic techniques. We report a unique case of a 51 year old patient presenting with an atypical inguinal hernia with concomitant inguinal and umbilical hernias in combination with cystic kidney disease and intracranial aneurysm. The atypical position of the hernia was assumed from clinical inspection, ultrasound and CT scan and verified during pre-peritoneoscopy. Using an anatomical cadaver dissection approach, we followed the unusual position of the hernia through the abdominal wall below the aponeurosis of the external oblique muscle. After a thorough literature search, we assume that the present hernia containing a hernial sac has not been documented before, especially not in such a multidisciplinary approach comprising radiological, surgical and anatomical localisation and endoscopic treatment in a patient with a clinical situation being aggravated by large cystic kidneys leading to dialysis-dependency. Rare hernias have been described as being often associated with concomitant inguinal or other hernias, a predisposition for the male gender and a pathogenic mechanism related to other soft tissue defects such as cystic kidney disease or cranial aneurysm. Thus, we consider this a unique case that has not been documented in this constellation previously, which may increase the awareness for these rare hernias.
    SpringerPlus 12/2015; 4(1):85. DOI:10.1186/s40064-015-0857-2