Amyand's Hernia With Sliding Component: A Case Report

Amyand's hernia (AH) occurs when the appendix becomes part of an inguinal hernia. Amyand's hernias are typically discovered incidentally during surgery due to their variable clinical manifestations and features, such as caecum and appendix forming the sliding component in the present case. Claudius Amyand operated it for the first time in 1735. Due to the simple presentations that these patients typically exhibit, the diagnosis is extremely challenging. The choice between surgical modalities is influenced by the numerous, logically accepted advantages and disadvantages of management modalities, which are subject to debate. That being said, we believe that, in the absence of sepsis or inflammation, open repair using mesh - as long as a clean operating room and competent surgical skill are available - should be the gold standard approach.

Gastric Outlet Obstruction from Stomach-Containing Groin Hernias: Case Report and a Systematic Review

Most abdominopelvic structures can find their way to a groin hernia. However, location, and relative fixation are important for migration. Gastric outlet obstruction (GOO) from a stomach-containing groin hernia (SCOGH) is exceedingly rare. In the current report, we present a 77-year-old man who presented with GOO from SCOGH to our facility. We performed a review of the literature following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) of patients presenting with SCOGH since it was first reported in 1802. Ninety-one cases of SCOGH were identified (85 inguinal and six femoral) over the last two centuries (1802-2023). GOO from SCOGH occurred in 48% of patients in one review and 18% in our systematic analysis. Initial presentation ranged from a completely asymptomatic patient to peritonitis. Management varied from entirely conservative treatment to elective hernia repair to emergent laparotomy. Only one case of laparoscopic management was documented. Twenty-one deaths from SCOGH were reported, with most occurring in early manuscripts (1802-1896 [n = 9] and 1910-1997 [n = 10]). In the recent medical era, outcomes for patients with this rare clinical presentation are satisfactory and treatment ranging from conservative, non-operative management to surgical repair should be tailored towards patients' clinical presentation.

Sliding Inguinal Bladder Hernia: An Open and Minimally Invasive Robotic-Assisted Repair

Inguinal hernia repair, although a common procedure, can present in complicated ways such as a sliding inguinal bladder hernia (IBH). This rare type of hernia can alter a patient's quality of life by obstructing urination, requiring manual scrotal compression to fully empty the bladder, and lead to devastating complications such as hydronephrosis and kidney failure. Treatment is typically by open inguinal hernia repair with manual bladder reduction, but this method poses risks of iatrogenic injury to the bladder. Within this case series, IBH repairs via open and robotic-assisted laparoscopic procedures are compared, and the morbidity and mortality of each method are analyzed. Although risk of recurrence is similar for both procedures, robotic surgeries are linked to decreased postoperative pain and length of hospital stay. The ease of dissection of pelvic anatomy and detailed view of the associated structures that robotic surgery can provide during a complex hernia repair encourages its use for IBH.

Pediatric ovarian sliding inguinal hernia, is surgical repair urgent?

OBJECTIVES

To find if repairing sliding inguinal hernias containing the ovary should be carried out urgently or not.

METHODS

A retrospective chart review carried out at King Abdulaziz Medical City, Riyadh, Saudi Arabia from 2015-2022. All cases with an ovarian inguinal hernia in females aged 0-14 years were reviewed after obtaining approval from the Institutional Review Board.

RESULTS

Female children with inguinal hernia patients were 191. A total of 28 cases were sliding inguinal hernias involving the ovary. All were repaired electively except for 4 cases that had an initial presentation of an incarcerated ovary at age less than 90 days which required urgent reduction and repair.

CONCLUSION

Based on our review, ovarian sliding hernias in female patients can be repaired electively, although newborns are at a higher risk of complications from sliding inguinal hernias.

Prenatal diagnosis of asplenia syndrome with sliding hiatus hernia in a fetus

We report a case of right isomerism with a complex congenital heart disease associated with hiatus hernia in a 19-week-old fetus with relevant review of literature. This report highlights the importance of having a proper checklist for prenatal identification of extracardiac manifestations of isomerism syndromes. This will enable us to provide an effective family-centered counseling for perinatal management of these complex lesions. To our knowledge, prenatal sonographic detection of a sliding hiatal hernia in a fetus with right isomerism has not been reported previously.

Large sliding inguino-scrotal hernia of the urinary bladder: A case report and literature review

RATIONALE

Sliding inguinal hernias of the urinary bladder are protrusions of the bladder through the internal inguinal ring, most of which are insignificant and diagnosed intra-operatively. Large inguino-scrotal bladder hernias commonly present with lower urinary tract symptoms and may cause severe complications, including bladder incarceration or necrosis, bladder hemorrhage, obstructive or neurogenic bladder dysfunction, and even renal failure.

PATIENT CONCERNS

We describe and discuss the clinical findings and management of a 59-year-old man who complained of a decrease in scrotal size after voiding and 2-stage voiding requiring pressure to the scrotum.

DIAGNOSES

The patient was diagnosed preoperatively as massive, bilateral, inguinoscrotal hernias, and a large, left-sided, sliding bladder hernia.

INTERVENTIONS

The patient underwent a timely open re-peritoneal inguinal herniorrhaphy using a mesh.

OUTCOMES

The surgical outcomes were good, and no surgical site infection, chronic postoperative inguinal pain or recurrence were recorded during the follow-up.

LESSONS

Better knowledge of this rare condition of large inguino-scrotal sliding bladder hernia could help in making a correct diagnosis preoperatively and provide proper surgical management timely, so as to reduce delay in treatment and avoid potential complications.

[Sliding ingvinal haernias in children]

AIM

To study the features of diagnosis and treatment of children with sliding inguinal hernias.

MATERIAL AND METHODS

30-year experience of treatment of 19 boys with sliding inguinal hernia and 1 boy with bilateral sliding femoral hernia was analyzed.

RESULTS

14 out of all children with inguinal and femoral hernia admitted with the diagnosis of incarcerated inguinal hernia. Accurate diagnosis was established during the operation as a rule. Surgical treatment of sliding hernias in children presents some difficulties. Intraoperative injury of bladder was observed in 2 children with sliding inguinal hernia. All children with sliding hernias have recovered after surgery.

CONCLUSION

Sliding inguinal hernia in children are rare, sliding femoral hernia is even rarer. In most cases children with sliding inguinal hernias are diagnosed with incarcerated inguinal hernia. Colon and bladder as the elements of sliding inguinal hernias remain viable after infringement.

Herniorrhaphy: an unusual cause of ureteral injury in Nigeria

Key Clinical Message

Herniorrhaphy is a common surgery worldwide. Common complications include hemorrhage, infection, chronic pain, and recurrence. Ureteric injury from herniorrhaphy is unusual. We present a case of ureteric injury complicating an inguinal herniorrhaphy for a huge right inguino-scrotal hernia. Patient had primary uretero-neocystostomy but died from septicemia in the postoperative period.