Najmaddini M, Mirshahi A, Shadravan MM, Zangane N, Mohammadifard M, Atary SK. A rare case of reduction en masse of incarcerated inguinal hernia: A case report.
Int J Surg Case Rep 2024;
122:110112. [PMID:
39146667 PMCID:
PMC11375273 DOI:
10.1016/j.ijscr.2024.110112]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2024] [Revised: 07/25/2024] [Accepted: 07/30/2024] [Indexed: 08/17/2024] Open
Abstract
INTRODUCTION AND IMPORTANCE
Reduction en masse is a rare complication of incarcerated inguinal hernias, occurring when the herniated sac, along with the trapped hernia, returns to the preperitoneal space.
CASE PRESENTATION
In this study, we describe a 74-year-old male patient who presented to the hospital with a history of manual hernia reduction and complaints of nausea, vomiting, and constipation for two weeks. After undergoing paraclinical tests, he underwent open surgery with a diagnosis of hernia reduction en masse, during which the hernia sac was separated from the surrounding structures. Abdominal and peritoneal defects were also repaired intra-abdominally. After his condition stabilized, the patient was discharged with prescription medications.
DISCUSSION
Reduction en masse in inguinal hernia cases is rare, where the hernia sac and intestinal contents are reduced while the intestine remains incarcerated. Computed tomography (CT) scans can aid in diagnosis, revealing characteristic features such as closed-loop obstruction and inguinal soft tissue changes. Treatment options include open laparotomy and laparoscopy, with laparoscopy being preferred depending on surgeon expertise, assessment of intestinal viability post-reduction, and patient stability.
CONCLUSIONS
The potential complications of hernia reduction en masse should be emphasized to patients who choose not to remain under medical supervision, as well as to physicians and surgeons when patients re-present following manual hernia reduction. Increasing awareness about this condition at relevant times is crucial.
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