Challenges and hurdles in managing giant inguinoscrotal hernia: A case report
More details
Hide details
Department of Surgery, Queen Elizabeth Hospital, Ministry of Health Malaysia, Kota Kinabalu, Sabah, Malaysia
Department of Surgery, Queen Elizabeth Hospital II, Ministry of Health Malaysia, Kota Kinabalu, Sabah, Malaysia
Department of Surgery, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
Submission date: 2023-03-04
Final revision date: 2023-10-30
Acceptance date: 2023-10-30
Online publication date: 2023-11-17
Corresponding author
Firdaus Hayati   

Department of Surgery, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, 88450 Kota Kinabalu, Sabah, Malaysia.
Pol. Ann. Med. 2023;30(2):153-156
A giant inguinal hernia is described as an extension of the hernia below the midpoint of the patient’s inner thigh in the standing position. It is relatively rare but severely affects a patient’s quality of life and imposes specific challenges to the surgeons.

The aim of this paper is to describe the management of giant inguinal hernia and its related challenges.

Case study:
A 51-year-old man, a chronic smoker, and a labourer at a construction site complained about a rapidly growing reducible right groin swelling with heaviness, and discomfort. He was counselled for surgical intervention a year earlier but defaulted on follow-up. There was a right giant inguinoscrotal swelling extending beyond the mid-thigh on standing position. He underwent inguinal hernioplasty successfully without any intra- or post-operative complication.

Results and discussion:
Challenges in managing giant inguinal hernias include loss of domain and a higher risk of cardiovascular compromises, intra- and post-operatively. Compared to other inguinal hernias, a giant inguinal hernia is also at a higher risk of surgical site infections, scrotal haematoma, and hernia recurrences.

A giant inguinal hernia is a rare and challenging surgical problem for surgeons. Meticulous perioperative managements are important in ensuring such patients with a promising outcome.

We would like to thank the Director General of Health Malaysia for his permission to publish this article as a case report.
None declared.
Authors declare that there is no conflict of interest.
Jenkins JT, O'Dwyer PJ. Inguinal hernias. BMJ. 2008;336(7638):269–272.
Kingsnorth A, LeBlanc K. Hernias: inguinal and incisional. Lancet. 2003;362(9395):1561–1571.
Zainudin S, Hayati F, Arumugam T, Ho KY. De Garengeot hernia: a rare case in an elderly woman and a review of operative approaches. BMJ Case Rep. 2021;14(4):e240557.
Devlin HB. Trends in hernia surgery in the land of Astley Cooper. In: Soper NJ, ed. Problems in general surgery. Vol 12. Philadelphia, PA: Lippincott-Raven, 1995;12:85–92.
Trakarnsagna A, Chinswangwatanakul V, Methasate A, et al. Giant inguinal hernia: Report of a case and reviews of surgical techniques. Int J Surg Case Rep. 2014;5(11):868–872.
Karthikeyan VS, Sistla SC, Ram D, Ali SM, Rajkumar N. Giant inguinoscrotal hernia-report of a rare case with literature review. Int Surg. 2014;99(5):560–564.
Birnbaum DJ, Gregoire E, Campan P, Hardwigsen J, Le Treut YP. A large inguinoscrotal hernia with stomach content. ANZ J Surg. 2011;81(1–2):86–87.
Vinod VC, Younis MU. Gastric strangulation and perforation caused by a giant inguinal-scrotal hernia. Turk J Emerg Med. 2021;21(3):122–124.
Panagiotakis GI, Spyridakis KG, Chatziioannou MN, Kontopodis NG, Kandylakis SE. Repair of an inguinoscrotal hernia containing the urinary bladder: a case report. J Med Case Rep. 2012;6:90.
Elstner KE, Moollan Y, Chen E, et al. Preoperative progressive pneumoperitoneum revisited. Front Surg. 2021;8:754543.
El Shamarka AH, Zidan MH, Youssef MS, El Banna AH, Mourad M. A case of giant inguinoscrotal hernia managed by preoperative pneumoperitoneum with an unforeseen complication and outcome: a case report and review of literature. Hernia. 2023.
Mehendal FV, Taams KO, Kingsnorth AN. Repair of a giant inguinoscrotal hernia. Br J Plast Surg. 2000;53(6):525–529.
Madyarov V, Malgazhdarov M, Kaliaskarov Y, Zhapbarkulova G, Amantayeva K. Method for the prevention of postoperative ventral hernias during surgical interventions on the anterior abdominal wall. Pol Ann Med. 2020;27(2):103–107.
Journals System - logo
Scroll to top