Sliding hernia.pdf

Sliding inguinal hernia continues to be the most challenging hernia to treat. Both diagnosis and treatment pose a
dilemma to the attending surgeon. Understanding the pathological anatomy of the sliding inguinal hernia is essential
for optimal choice of surgical procedure without causing damage to the involved viscera. A case of sliding inguinal
hernia is presented to highlight the diagnostic and technical challenges for repair of sliding hernia. Majority of sliding
hernias are diagnosed at the time of surgery. Sigmoid colon is a commonest content in a left sided sliding hernia.
Bevan’s technique is best suited to deal with the sac followed by Lichtenstein tension-free mesh repair.

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Case Report 2

Sliding inguinal hernia: a technical challenge
Ketan Vagholkar”, Tanay Purandare

Deporte Stray, DY: Pal Univesity School o Medicine, Noi Mamba, Mahara, ndo

Received: 07 Fanny 2023
Accept: 05 uly 2023,

scorespandenc
De. Kan Vashoba,
Em Rraghoar@yalon com

Copyright © the ut), publier and ice Medip Academy This isan open-access it ditu under
theta of te Grave Commons uit Non Cini Liceos, hich pers unsere ancora
‘ee, dui, andere a media provided te oil work propery ite.

Sliding inguinal mia cotes o be he mos callengne han to tea. Both dignos and wesen pose à
¿lena ote aeg sracon Understanding the paola maton fe ling ail hema s cuen
fer optimal chic of suica procedure witout casing damage tothe mld ira À case of sing inguinal
ten reset to highlight the inne an teca! challenges for par o ss hin Map ii,
Fins re dagsed a he ine of surgery. Sipnoi colon a commonest cont in a I ied sie hm

‘Keyword Sliding, nina Hen, Trenet

‘eva tique best to deal wh he ac folowel ty Lichte tes see meh ea

INTRODUCTION

fiat described by Gallen nd er decried. Ya
masi by Antero Spa > The mos precine un of
ina à siding mal hen à when the vse
cesta pat of the wal ofthe sc. In ether werd,
mation of the etapa! sic a an gan On
the lt rie the content sy de Sol colon
Followed bythe wiry blader Whereas on te ih
side the con e uly the cam and append.
followed by the way Der 1 3 que diel to
digue à siding hamia precpentive. A case of
Sis inal haria ccm the no clon $
reset

CASE REPORT

A Stycaroló male ptt presented with a le Ket
Sided mgunoseul suena. The durin af the
‘vein war Jean The pelin had creed ss
Dre à paid of tine and Ind became elle Thee
‘was no hin of spams mere of oben,
‘angulation ain bowel hai

Pal examination. reveled large panal
‘rede et se guinea hein À USG of te
Seng reveled Dovel” oops Paint nde
Sil repair under resina anesthesia The sc vas
Hid and decode fen he cord iros The
ents o the sac cout bereduc fly. The ac was
pened taste ste. The cono was age lah of
the iano colon Fire D.

eran tique was wei to deal wih thes are

"An invatesU-Shaped isin ns made parallel sid
À en may fom the tate he so nd loi
colon up lo the dsp rin The sigmoid colar was
Sopas back ithe persenen eaiy and dele in
thea ofthe sa war tard th 30 marie These
as closed by a use sing str ah wäh the pane of
le inferir cpg any The anse fac was
pleted va tente 2-0 Prolene sate A tence
fice Lichtenstein me par was done

‘The ser ofthe incision wre closed. À im scrotal
por war given for 49 hours Skin spl were
removed on he ih postoperative day. Pat as es
Flia up Tr eae Sear wäh no evidence of the

neon Sy Js At 2023| Vl 10 anes Page 0

2. ‘Piguet: Lf sided dng inguinal Nera containing

Ihe siga elon,

igure 2: Dealing wit the ac by Reva’.

Sing inguinal emia ci to pose bath a
ie and susie den Shing a
em is secte wih a ihe recuento as
crazed o lr tial haminı Complete sen
the sbnomal any of ths hem e sl o

prev "damage to Ihe vice da
Sant hi ca sa una nna
shuld raise he pion Fa ling hea

Imaging modas will rev bowel a ih cement.
Cours eae computed tomography (CECT) will
oval the ate of cos in à tape inner
mia indie the presence of te sei colon er an
fiber icra the a. is re ale pace o

el og J 2028 ulm.

15 CECT don inte nis seins bee
gay. This provides rnd map for demini the
Wests ep or rea

Maori of cases repre in rare have deserved
Uat e digo of ling inal hama made on
table” Due tothe ite anatomy ofthe sc. ection
eds tobe dee coral molins jy 1 the colon
The sc needs oe spare om he card tres
th ret eae al lc te leh wp tothe dec rin.
‘The oe den opened ae ¡dni a safe area whee
ee no dans seer palpable

The gs ten one fr opening the sa. No
pt on be muet dss gad cola dan the
fae ot ape fo be exapetoneal portion a the
void cok Wat coito, the wall of the sc
era tehnique sate option to dea with these
An end Use meinen tv made où the 1 em
Tara and paralelo the extapeitonel potion ofthe
gai colon“ enable de colon 1 be reposo
back it the parten ca, The defect hos rte in
the sue ar prteenliang the signoi clon de
‘dood wit 30 meule Te bat sc e therefore
‘ecole having reprcacale the colon. The
pati à gen Henlow pouton to enure dat
Entrena ces fl aa rm he te The neck
Sinne limita 3 manik pane dng ae

"Transversal fin sould be plated with tempted
polipropileno 20 mrabsobable miure Tt add
Arena tothe weak pestaior wall À
Cisne tier med reper cm then de
pme This pate of rpar fora din tua
Hein in acts wih a vey ow incidence of
resumen compared 10 old rope dest by
Toque” Laprescopic aprach ha be Scribd fer
Imani sing il Hern However, he ron

CONCLUSION

A pat edie ingl emia epeily en te
ie side should ase the suspicion of iia Hemi
Te diagonal hema intra dene on the
operating ble during the couse of ange Bera
qe provides a af pin for dealing with Se ee
A Liens terse fe mesh rep reihen: the
postr wall they recs the rue rt 10 à
Bee mm

nit schol of medicine Navi Mb, India for
pement publish the ase rept.

arbre: fang sources
Cont ef rest ne declared
Bal appro: Notare

Intenso Sry Jarl Au 2023 VA 10 anes age

3. Paper Ket ep 228g 101402

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‘ite his are as: Valle K. Prado,
Sie nail ena cil halte at
Surg) 20251014002

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