A case of false reduction of an inguinal hernia

Abstract

A 56-year-old male was referred to our hospital because of persistent ileus after reduction of a left inguinal hernia. On admission, although no herniation was observed in the inguinal region, the patient had abdominal bulging and pain. Strangulation ileus was suspected by CT scan because of a partially dilated intestine associated with a thickened wall and hydrocele-like mass seen in a narrow space between the preperitoneal space and scrotum. During emergency surgery, we released the strangulated small intestine via an abdominal approach. A 20 cm portion of the incarcerated intestine fell into the preperitonal space covered with the hernia sac. Intraoperative observation revealed that a herniation ring strangulating the intestine was composed of hypertrophic peritoneum, confirming that the strangulation ileus was oaused by false reduction of an inguinal hernia. Subsequently, the herniation was repaired using the Kugel procedure via an inguinal approach. Here in, we discuss the cause, diagnosis, and treatment of false inguinal hernia reduction which ocours under extremely uncommon conditions.