Abstract
The patient was a 60s male. Anemia was detected on a medical check-up. Sigmoid colon cancer was diagnosed by colonoscopy, and the patient was referred to our hospital. On physical examination, a large mass measuring 30 cm extending from right inguinal lesion to right lateral middle abdomen was noted. On abdominal CT, the small intestine prolapsed into the lateral abdomen through the right inguinal region, and the patient was diagnosed with right inguinal hernia. The testis was localized in the right inguinal region on CT. Based on the above diagnosis, sigmoidectomy for sigmoid colon cancer, repair of the right inguinal hernia, and right orchiectomy were simultaneously performed. On laparoscopy, right external inguinal hernia was observed, and the small intestine prolapsed through the hernia orifice. We tried to reduce the small intestine, but it was impossible due to severe adhesion. Surgery was converted to laparotomy, and the adhesion was dissected. The inguinal hernia was repaired with an anterior approach employing the Lichtenstein method, followed by sigmoidectomy and right orchiectomy. It was assumed that the spermatic cord could not reach the scrotum due to accompanying undescended testis, which extended the hernia sac from the right lower to lateral subcutaneous abdominal region.
