A Clinical Image of Sliding Hernia

Abstract

A 55-year-old male patient was admitted with complaints of leftsided inguinoscrotal swelling for one year. The patient did not have any associated co-morbidities. After a thorough clinical and haematological assessment, the patient was taken up for elective inguinal hernioplasty and Lichtenstein tension-free mesh repair. During the surgery, the hernial sac was identified and dissected from the spermatic cord; during this stage, part of the sigmoid colon was found to be part of the posterior wall of the sac [Table/Fig-1], leading to the diagnosis of a sliding hernia. It is crucial to perform gentle dissection to avoid injury to the contents of the sac. After identification, the viscus was meticulously dissected and reduced to the preperitoneal space without excising the sac. Subsequently, a herniorrhaphy with Lichtenstein’s tension-free mesh repair was performed. The rest of the procedure was uneventful. The patient was eventually discharged following suture removal and kept on regular follow-up. He did not developed any postoperative complications following the surgery.

Keywords

• hernia repair
• hernioplasty
• inguinal hernia
• sigmoid colon