Khatiwada Pradeep, Devkota Amrit, Panthi Sagar, Manandhar Srista, Sharma Dipendra, Chhetri Sunit, Ranabhat Chet Bahadur, Shah Suresh, Khanal Bhawani
Department of General Surgery, B.P. Koirala Institute of Health Sciences, Dharan 56700, Nepal.
J Surg Case Rep. 2021 Oct 28;2021(10):rjab458. doi: 10.1093/jscr/rjab458. eCollection 2021 Oct.
In this modern era, giant inguinoscrotal hernias are very rare to experience in a medical career. We discuss a case of a 65-year-old man with a history of an inguinoscrotal hernia with progressive growth for the past 35 years. On examination, he had a 20 cm × 15 cm non-reducible swelling with multiple ulcers over the skin surface extending to the mid-thigh with otherwise no other bladder and bowel complications. These large hernias pose a different set of surgical problems. Open surgery was performed, hernial sac opened, contents reverted and left orchidectomy were done with scrotal reconstruction. The defect was closed with Vicryl 1-0 over the muscle layer and the skin was stapled. Daily wound care was provided. Besides, this case also compels us to explore possible reasons for the occurrence of such potentially dangerous surgical problems in low-to-middle income countries (LMIC).
在当今这个时代，在医疗职业生涯中遇到巨大腹股沟阴囊疝的情况非常罕见。我们讨论一例65岁男性病例，该患者有腹股沟阴囊疝病史，在过去35年中逐渐增大。检查发现，他有一个20厘米×15厘米的不可复性肿胀，皮肤表面有多处溃疡，延伸至大腿中部，除此之外没有其他膀胱和肠道并发症。这些巨大疝带来了一系列不同的外科问题。进行了开放手术，打开疝囊，回纳内容物，并进行了左侧睾丸切除术及阴囊重建。用1-0薇乔缝线在肌肉层上方关闭缺损，皮肤用吻合器缝合。提供每日伤口护理。此外，该病例也促使我们探究在中低收入国家出现此类潜在危险外科问题的可能原因。
