A giant inguinoscrotal swelling with intestinal obstruction – a case report

Giant inguinal hernias are unusual and are extremely rare nowadays because of easier access to hospital services, early diagnosis better hernioplasty techniques. They are significantly challenging in terms of surgical management. It is defined as an inguinal hernia that extends below the midpoint of inner thigh when the patient is in standing position. They can either be asymptomatic or can present with complications. We report a case of a 68-year-old male who presented with features of intestinal obstruction. The patient was found to have giant right-sided inguinal hernia with ipsilateral hydrocele for 12 yrs that was extending almost up to the patient’s knee joint and it was tender, irreducible without a cough impulse. He had no cardiorespiratory illness. Emergency exploration via inguinoscrotal approach revealed that contents were the small and large intestines, omentum and mesentery. Right orchidectomy, omentectomy and reduction of contents into abdominal cavity followed by a double-layered closure of wall, and scrotoplasty were done.