A case report of sliding inguinal hernia containing ascending colon, caecum and whole of ileum with its mesentery as its content

Abstract

Introduction

Inguinal hernia is quite common in surgical practice. However, sliding hernia is rare with an incidence of 2–5%. The exact diagnosis of sliding hernia is made on the operating table. We report the case of sliding hernia containing caecum, appendix and ascending colon forming the sliding component.

Case report

A 45-year-old gentleman presented with huge right sided groin hernia. Patient was operated under spinal anaesthesia, reduction of the hernia was tried but it could not be reduced fully. Hence, very carefully the sac was opened and was found to contain ascending colon, caecum with appendix forming its posterior wall. There was whole of ileum with its mesentery as its content. The contents were reduced and the sac was closed carefully. Posterior wall was reinforced with prolene mesh. Patient was discharged after 2 days.

Conclusion

Sliding hernia is a rare entity and those containing transverse colon, ascending colon, caecum and appendix are even rarer. Care must be taken to identify the contents of the hernia to avoid inadvertent injury to the structures.