Management of rare and atypical inguinal hernias: our experience at a tertiary care centre


  • V. Sai Prasuna Department of General Surgery, NRI Medical College, Chinakakani, Andhra Pradesh, India
  • Y. Prabhakara Rao Department of General Surgery, NRI Medical College, Chinakakani, Andhra Pradesh, India
  • C. Akhilesh Department of General Surgery, NRI Medical College, Chinakakani, Andhra Pradesh, India



Inguinal hernia, Loss of domain hernia, Mesenteric cyst, Ogilvie’s hernia, Ureteric hernia


Background: Inguinal hernia is one of the most common surgical conditions operated by the surgeon. The purpose of the study paper was to provide diagnostic and therapeutic resources to deal with certain difficult situations in hernia repair.

Methods: A retrospective analysis of 8 rare and atypical inguinal hernias was conducted for a period of 2 years at NRI General Hospital, which includes cases like Loss of domain hernias and hernias with atypical contents; which stood as diagnostic and management challenge to the surgeon.

Results: Of the eight very rare and atypical cases operated, no postoperative complications were noted except one which developed a scrotal abscess after one month of discharge.

Conclusions: The infrequent encounter with rare and atypical hernias stands a diagnostic challenge to the surgeon. Inguinal hernia repair even-though looks simple yet may sometimes be very difficult.


Townsend CM, Beauchamp RD Jr., B. Evers M, Mattox KL, eds. Hernais. In: Sabiston textbook of surgery: the biological basis of modern surgical practice. 20th edition. Inc Chapter 44. Elsiever; 2016: 1092.

Wagner JP, Brunicardi FC, Amid PK, Chen DC. Inguinal hernias. In: Brunicardi FC, Dana K. Andersen DK, Billiar TR, Dunn DL, Hunter JG, et al, eds. Schwartz’s Principles of Surgery. 10th edition. Mc Graw Hill Inc; 2015: 1495.

Jain R, Venkatesh K, Management of various rare and atypical hernias: experience at a tertiary care centre in central India. Int Surg J. 2016:3;146-52.

Qaja E, Le C, Benedicto R. Repair of giant inguinoscrotal hernia with loss of domain. J Surg Case Rep. 2017;2017(11):221.

Gill WG. Direct inguinal hernia. Br Med J. 1939;1:263.

Craig C. A note on Ogilvie’s tubular direct hernia. Med J Aust. 1946;2(20):705.

Ogilvie H, Hattingh PW. An unusual type of hernia. Lancet. 1953;261(6767):950-1.

Codognotto E, Kiss A, Meo G, Olivero G, Taliente P. Rare abdominal wall hernias in South Sudan. South Sudan Med J. 2013;6(2):28-30.

Yahya Z, Al-habbal Y, Hassen S. Ureteral inguinal hernia: an uncommon trap for general surgeons. Case Rep. 2017;2017:bcr2017219288.

McKay JP, Organ M, Bagnell S, Gallant C, French C. Inguinoscrotal hernias involving urologic organs: a case series. Can Urol Assoc J. 2014;8:E429-32.

Lu A, Burstein J. Para peritoneal inguinal hernia of ureter. J Radiol Case Rep. 2012;6:22-6.

Obaidah A, Mane SB, Dhende N, Acharya H, Thakur A, Arikar J, et al. Mesenteric cyst- an unusual presentation as inguinal hernia. Indian J Surg. 2012;74(2):184-5.

Kassir R, Dubois J, Berremila SA, Baccot S, Boueil-Bourlier A, Tiffet O. A rare variant of inguinal hernia: Cryptorchid testis at the age of 50 years. Etiopathogenicity, prognosis and management. Int J Surg Case Rep. 2014;5(7):416-8.

Singh D, Aga P, Goel A. Giant unilateral hydrocele “en-bisac” with right hydronephrosis in an adult: a rare entity. Indian J Urol. 2011;27(1):142.

Doudt AD, Kehoe JE, Ignacio RC, Christman MS. Abdominoscrotal hydrocele: a systematic review. J Pediatr Surg. 2016;51(9):1561-4.

Gadelkareem RA. Abdominoscrotal hydrocele: A systematic review and proposed clinical grading. Afr J Urol. 2018;24(2):83-92.






Original Research Articles