Non-obstructed femoral hernia containing ascending colon, caecum, appendix and small bowel with concurrent bilateral recurrent inguinal hernia

Abstract

Femoral hernias, which are less common than inguinal hernias and more often found in females, occasionally contain more than just small intestine and omentum. Uncommon contents reported in femoral hernia sacs include caecum, appendix, Meckel's diverticulum (Littre hernia), testis, ovary, transverse colon and even stomach or kidney. Strangulation of femoral hernias containing appendix, small intestine and caecum, and Meckel's diverticulum are well reported in the literature. Here, we report a case of a male patient having bilateral femoral hernia with bilateral recurrent inguinal hernia. A huge, right-sided femoral hernia contained terminal ileum, appendix, caecum and ascending colon, which were irreducible but neither obstructed nor strangulated. The patient was operated on with a Pfannenstiel incision together with an infrainguinal incision. For reduction of content, an inguinal ligament was also incised. Bilateral preperitoneal, polypropylene mesh hernioplasty was performed along with rolled plug placement in the right femoral canal. The patient had an uneventful post operative recovery and no recurrence in 6 months of follow up.