1/12. Repair of a giant inguinoscrotal hernia.We present a case of a long-standing, giant inguinoscrotal hernia extending to the patient's knees, complicated by intestinal obstruction. Initial management involved conservative treatment of the intestinal obstruction and optimising the patient's general condition. Surgical treatment included debulking the contents of the hernia sac by performing a right hemicolectomy and a small bowel resection, and reconstruction of the abdominal wall using Marlex mesh and a tensor fasciae latae flap. Although abdominal wall reconstruction for massive ventral or incisional herniae is well reported, inguinoscrotal herniae of this magnitude are much rarer and pose additional problems, which are discussed in this paper.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
2/12. pneumoperitoneum in repair of giant hernias and eventrations.The common use of laparoscopy has made many surgeons familiar with the use of pneumoperitoneum. It is important to know the therapeutic advantage of this technique in the repair of giant hernias and eventrations where the viscera are forced out of the abdominal cavity.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
3/12. Giant inguino scrotal hernia: a case report.Giant inguino--scrotal hernia is largely a problem of developing countries. A case of an unusually giant inguino-scrotal hernia is reported highlighting the problems encountered in management. Orchidectomy, bowel resection and relaxing epigastric incision were successfully employed in repairing the hernia. Hernias may not be difficult to manage if they ar not neglected. Efforts of health education need intensifying in this direction. We propose thorough peri-operative pulmonary exercises to cut down the post-operative pulmonary morbidity.- - - - - - - - - - ranking = 0.2keywords = giant (Clic here for more details about this article) |
4/12. Approach to a giant inguinoscrotal hernia.We present an extremely huge and longstanding, giant inguinoscrotal hernia extending to below the knee with an ulcer at its base. Though hernias of this magnitude are rare, their management can be demanding and challenging. Nevertheless, in an emergency situation, the repair of the hernial defect is not essential, especially in a compromised patient. In fact, the most important step is excision of the devitalised tissue, and the final surgery can be delayed. In nonemergency management, definitive surgery can be planned either by a period of preoperative staged pneumoperitoneum, repairing after a resection of bowel and omentum, or replacing the content and ventilation of the patient to avoid the pressure on the cardiorespiratory system by forcing the tissue. This case highlights the problems encountered in management of huge hernias.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
5/12. Bilateral inguinal hernia with dislocation of great saphenous vein as complication of long-standing granulomatous slack skin: a case report.Granulomatous slack skin (GSS) represents a rare variant of mycosis fungoides, histologically characterized by a variably deep T helper lymphocytes infiltrate with alteration of the dermal elastic tissue and consequent elastolysis, elastophagocytosis and numerous giant cells. Clinically, a development of unelastic, slack skin, especially on flexural areas, is observed. Hereby, we describe a man with a 12-year history of GSS. In 2002, for practical (limitation of movement, deambulation) and cosmetic reasons, he underwent the surgical excision of loose and sagging skinfold over inguinal area, and, afterwards, of the opposite affected inguinal skin. The surgical treatment of bilateral inguinal hernia with reposition of inguinal dislocated vasculature is also reported. In both cases the excised material confirmed the former diagnosis of GSS and revealed a very deep, muscular infiltrate of neoplastic lymphocytes. One year later, a new excision of GSS on the axillae was made. Now, after 2 years, deambulation keeps improving, although an initial relapse of the inguinal slack skin has been observed.- - - - - - - - - - ranking = 0.2keywords = giant (Clic here for more details about this article) |
6/12. Direct inguinal hernias in the newborn.Direct inguinal hernias occur in newborn babies, both term and premature. Five cases are reported to illustrate three types of direct hernia. The first is a direct weakness without associated significant indirect hernial sac; the second, a sliding direct hernia. The third might be called a 'secondary' direct weakness resulting from a primarily indirect hernia which assumes such large size and develops such a wide neck at the internal ring that the posterior wall of the inguinal canal is stretched and weakened. This is most likely to occur in very low birthweight babies, who develop giant inguinoscrotal hernias. Full exploration and repair of the posterior wall of the inguinal canal should be performed in such babies with huge indirect hernial sacs and in all babies where the size of the processus vaginalis identified at the internal ring is not consistent with the hernial swelling identified clinically. Repair should be performed in conventional manner with non-absorbable sutures reinforcing the transversalis fascia. Overlying Bassini repair with or without Tanner's slide can be performed. The repair should be carried out before the baby leaves a high dependency area.- - - - - - - - - - ranking = 0.2keywords = giant (Clic here for more details about this article) |
7/12. Giant inguinal hernia in a 5-year-old boy with hydrocephalus: a case report.A case of giant left inguinal hernia in a 5-year-old boy is presented. The patient had multiple neurosurgical procedures performed in the neonatal period for spina bifida and hydrocephalus, including the placement of a ventriculoperitoneal shunt. The hernia was first noted during this period but was not repaired, and the child was lost to follow-up until age 5. The hernia underwent progressive enlargement over this interval, and the eventual development of gastrointestinal symptoms prompted the "rediscovery" of the defect. The majority of the child's intestines were within the hernia, with at least partial loss of domain. The unique preoperative and postoperative management of this difficult problem is described.- - - - - - - - - - ranking = 0.2keywords = giant (Clic here for more details about this article) |
8/12. Scrotal reconstruction for giant inguinal hernias.Giant inguinal hernias require special consideration for repair of the abdominal wall. The associated greatly thickened, enlarged scrotum should be discarded and a neoscrotum should be reconstructed from the uninvolved perineal-scrotal skin. A cloverleaf design flap is used for this reconstruction.- - - - - - - - - - ranking = 0.8keywords = giant (Clic here for more details about this article) |
9/12. Unusual parascrotal hernia with ectopic testicle in a neonate. Case report.A giant indirect inguinal hernia leading to a huge parascrotal mass in a newborn is described. The right scrotum was empty and the ectopic testicle was found in the perineum, close to the anus. To our knowledge this is the first report of the presence at delivery of a parascrotal inguinal hernia in combination with an ectopic testicle.- - - - - - - - - - ranking = 0.2keywords = giant (Clic here for more details about this article) |
10/12. Scrotal reconstruction for giant inguinal hernias.A case of inguinal hernia with massive scrotal enlargement is presented. walking and voiding had become extremely difficult for the patient; only one testicle could be palpated, and the penis could not be delivered from the scrotal mass. Surgical reduction of the massive hernia was accomplished. The right testis with its spermatic cord had to be sacrificed; the left one was normal, although the cord was elongated. The main bulk of the enlarged scrotum was excised, and a neoscrotum was created from perineal skin; orchiopexy on the left was carried out. Healing has been uneventful.- - - - - - - - - - ranking = 0.8keywords = giant (Clic here for more details about this article) |
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