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Giant inguino-scrotal hernias are those that extend below the midpoint of the inner thigh when the patient is in the standing position. There are three specific problems with management of these giant inguinal hernias: the "loss of domain" of the bowel, the high risk for recurrence, and the residual exuberant scrotal skin. A fundamental part in the treatment of patients with large hernias is represented by a careful preoperative investigation using MR and, if necessary, CT scan to exclude neoplastic pathology in the context. In this article, we describe the case of an obese patient suffering from Von Recklinghausen syndrome carrying a giant left inguino-scrotal hernia. A wide left inguinotomy partially extended to the scrotum was performed. In the hernia sac, the colon was completely collapsed and floating as it was entirely free from any intra-abdominal anatomic anchoring points. After a radical needful omentectomy, the trasversalis fascia and the internal inguinal ring were reconstructed with a polypropylene mesh placed in the pre-peritoneal-retro muscular space. A second wider polypropylene mesh was positioned above the muscular abdominal plane fixed to the pubic tubercle. [ABSTRACT FROM AUTHOR]

Inguinal hernia repair is the most common surgery done by both young and experienced surgeons. The hernia in the inguinal region usually contains the omentum and small intestine but rarely can contain unusual contents like the appendix, ovary with fallopian tubes, urinary bladder, sigmoid colon, and cecum. The aim of this study is to present our experience of uncommon contents in the inguinal hernia sac and their surgical management. A retrospective study of 330 patients who underwent inguinal hernia repair was carried out over a period of 3 years from January 2008 to December 2011. Only five patients presented with unusual contents in the inguinal hernia sac; an incidence of 1.5 %. Two of them had vermiform appendix, with acute appendicitis (Amyand's hernia) noted in one of them. The patient with acute appendicitis underwent appendicectomy with herniorrhaphy, while in the other, hernioplasty with mesh was done as the patient was with normal appendix. In one case, the urinary bladder was the content of the inguinal hernia sac and there were two cases with the ovary and fallopian tubes as its content. In all these cases, contents were replaced back and hernia repair was done. Unusual contents of the hernial sac may create a surgical dilemma (whether to save or sacrifice the organ) during hernia repair even to an experienced surgeon. [ABSTRACT FROM AUTHOR]

An inguinal hernia containing appendix is termed an Amyand's hernia. It is an uncommon and rare condition estimated to be found in approximately 1 % of adult inguinal hernia repairs. Depending on the extent of inflammation in the hernia sac and obstruction of hernia, clinical presentation can vary. We report a case of Amyand's hernia in a 22-year-old male who presented with history of right inguinal hernia for 6 months duration. Operation revealed hernia sac containing inflamed appendix hence appendectomy was performed. [ABSTRACT FROM AUTHOR]

Amyand's hernia is a rare condition in which the appendix is positioned in the inguinal hernia sac. Mucinous cysadenoma of the appendix is rather extremely rare. We report a case of a mucinous cystadenoma of the appendix which presented as an incarcerated right indirect inguinal hernia (Amyand's hernia) [ABSTRACT FROM AUTHOR]

Amyand's hernia refers to the presence of the appendix within the hernial sac. Though it was first described 270 years ago in an 11 years old boy, it remains relatively unknown because of the rarity of its occurrence. It usually occurs on the right side. We are reporting a very rare case of left sided incarcerated Amyand's hernia in an 11-month-old boy. [ABSTRACT FROM AUTHOR]