Abstract
A 75-year-old man was seen at the hospital because of a left inguinal bulging and left inguinal pain, when his scrotum had enlarged to be the adult's head size and the penis had been buried. Following an abdominal CT scanning, left inguinal hernia containing the sigmoid colon was diagnosed. Our attempt at repositioning the sigmoid colon by hands was unsuccessful and then emergency operation was performed. When the left inguinal region was incised to release the inguinal canal, the prolapsed sigmoid colon was confirmed, however, it was difficult to reduce the herniated colon by the inguinal method. The herniated sigmoid colon was able to be reduced by operations through an additionally made midline incision. Using a Direct Kugel Patch (size M), the hernia orifice was repaired. The patient's respiratory condition became worse due to an increased intra-abdominal pressure postoperatively, and we had to manage him under artificial respiration but could extubate on the 3rd postoperative day. Thereafter his clinical course was uneventful, and he was discharged from the hospital on the 9th postoperative day. No recurrence of hernia has occurred up to now.
