A SCROTAL ABDOMEN IN AN ELDERLY PATIENT MANAGED BY HERNIOPLASTY WITHOUT DEBULKING OF THE HERNIA CONTENTS: A CASE REPORT AND LITERATURE REVIEW

Abstract

Background: Scrotal abdomen is not a common today, but most challenging case even in experienced general surgeon, as there is no standard surgical procedure. They present as a huge inguinoscrotal swelling for a longstanding, neglected to treatment, because fear of operative intervention and remote places where medical service is inadequate. The morbidity and mortality also high because of forced reduction of the herniated viscera to the abdominal cavity, which is accustomed to being relatively empty for long duration, may cause alteration in the intra-abdominal and intra-thoracic pressures, leading to complications such as ACS, precipitation of cardiovascular or respiratory compromise, hernia recurrence and wound dehiscence . We present this ca Case presentation: se of giant inguinoscrotal hernia of a 72 years old male who had difculty in performing his daily activities. Patient underwent emergency mesh repair after reduction of content through inguinal approach. Giant inguinal hernia containing almost whole abdomen with terminal 50 cm ileum, caecum, appendix, ascending colon, hepatic exure of colon and transverse colon with omentum in the hernia sac and the patient had an uneventful recovery with eventual discharge on postoperative day 8. The giant inguinal hernias are uncommon in today's surgical Conclusion: practice. Management of which is challenging with grave complications but early intervention and postoperative monitoring to raised IAP and its complications which can save the patient. We report this case of an elderly patient with an acute presentation of scrotal abdomen with contents as both direct and indirect component which has been managed successfully with tension free open mesh hernioplasty and biological repair without debulking of the hernia contents and this case supported by a review of the literature.