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TITLE:

UNUSUAL CONTENTS IN INCARCERATED INGUINAL HERNIA

AUTHORS:

Aliza Saeed*, Dilgosha Khan

ABSTRACT:

Aim: Inguinal hernia when incarcerated may present an emergency due to the impending danger of strangulation and subsequent necrosis of its contents. Intra-abdominal organs, e.g. small intestine, omentum, colon are commonly found in incarcerated inguinal hernia. However, some contents are reported rarely including vermiform appendix, acute appendicitis, Meckel's diverticulum, epiploic appendagitis, ovary, fallopian tube, urinary bladder diverticula. Medical professionals must be aware of unusual contents to plan effective management of the problem. Technique: In the present study, we compiled case studies on unusual contents of incarcerated inguinal hernias reported in research journals from 2000 through 2020. The purpose is (i) to find out the incidence of unusual contents in inguinal hernias (ii) to find out frequencies of particular content in inguinal hernias (iii) to study the clinical presentation of specific unusual content of hernia (iv) to examine the age and gender distribution in cases of unusual contents of inguinal hernias. Results: We compiled sixteen (16) case reports and three (3) review articles from the literature. Among the unusual contents appendix, acute appendicitis, ovaries, fallopian tubes, urinary bladder diverticulum were frequently reported. Unusual content showed age-specific and gender-specific distribution. In general adult male were more affected than female. Urinary bladder diverticulum was commonly found in old males with a history of prostate hyperplasia. All of the cases for ovary, fallopian tubes were observed in female infants. Amyands hernia was more common in children than in adults. Cases of the stomach, ascitic fluid, Mekel diverticulum (Littre's hernia), epiploic appendagitis, splenogonadal band were also reported. Clinical features were also content specific with a mild variation. Bilateral inguinal hernia with ovaries and fallopian tubes was also reported. Conclusion: Unusual contents of inguinal hernia are rare surgeons must be cautious of them. Clinical picture, physical examination and radiological assessments all should be done exhaustively to confirm the source of the hernial content. Keywords: incarcerated inguinal hernia, unusual contents, case studies

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