Port of entry Patients, n Hernia side, n Right Left
Hernial sac 124 74 50 Umbilicus 76 62 14 Total 200 136 64 Table 3: Correlation between age, contralateral patent processus vaginalis (CPPV), and clinically elucidated contralateral hernia.
Sliding hernias are those in which typically the posterior part of the wall of the
hernial sac is formed by a viscus and/or its mesentery.It is a rarity for a sliding hernia to present with symptoms of pain, as there are very little chances of it strangulating or becoming obstructed.
A preoperative diagnosis of scrotal cystocele allows to place a urethral catheter, with the aim to decompress the bladder before surgery and to fill the bladder with saline fluid and a blue dye (methylene blue) intraoperatively, in order to help surgeon to better identify the
hernial sac content and to preserve urinary structure integrity.
Few prominent vessels in the
hernial sac were identified and a vessel sparing ligation of the sac was done at the deep ring.
Ligation of
hernial sac, use of clamps, suturing of
hernial sac and radical operation are normally performed to correct the umbilical hernia, although open herniorraphy is the most common method of treatment (O'Connor, 1980).
Intraoperatively, the appendix and the caecum were found to be present in the
hernial sac and both were in viable condition.
In addition, surgical manipulation to achieve visualization of the entire appendix and its base by enlarging the hernial defect or distending the neck of the
hernial sac increases the possibility of recurrence by weakening the anatomic structures around the defect.
Under strict asepsis, an elliptical skin incision was made over the swelling for resecting infected tissue and separation of adhesions between
hernial sac and abomasum.
Hernioplasty was done and
hernial sac was sent for routine histopathological examination.
Presence of a uterine horn and fallopian tube within an indirect
hernial sac: report of a rare case.
In 1982, Ger attempted minimal access groin hernia repair by closing the opening of an indirect inguinal
hernial sac using clips.
Motile intestinal loops were palpable within the
hernial sac. To confirm the diagnosis, trans-abdominal real time B-mode ultra-sonography was conducted using 3.5-5 MHz convex transducer in sagital and transverse plane was performed and revealed fluid filled motile intestinal loops beneath the skin in the
hernial sac (Fig.