Internal and External Inguinal Hernias Coexisting with a Femoral Hernia-like Lesion in an Older Male—A Case Report—

Abstract

An 84-year-old male had been aware of a right inguinal bulge for three months before presenting at our hospital. The patient was referred to our hospital because a right internal inguinal hernia was suspected on computed tomography (CT). Based on the CT findings, a right internal inguinal hernia equivalent to the new Japan Hernia Society (JHS) classification, M2, was diagnosed, and trans-abdominal pre-peritoneal repair of inguinal hernia (TAPP) was performed as a standby procedure. Observation of the abdominal cavity revealed 2.5 cm and 2.0 cm sized hernial orifices on the inner and outer sides of the inferior epigastric vessels, respectively. Right M2 and right L2 types were diagnosed, based on the new JHS classification. Dissection of the pre-peritoneal cavity also revealed a 1.5 cm-sized hernial portal in the femoral ring. This is a previously unreported very rare case of internal and external inguinal hernias coexisting with a femoral hernia-like lesion.