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Multiple concurrent bilateral groin hernias in a single patient; a case report and a review of uncommon groin hernias: A possible source of persistent pain after successful repair

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ABSTRACT

An occult hernia is a hernia where physical examination fails to demonstrate a hernia mass or defect, but a hernia is identified on surgical exploration.

Multiple simultaneous occult hernias can be completely asymptomatic or it may present with unexplained chronic groin or pelvic pain.

MRI is the most accurate preoperative and postoperative diagnostic tool to image an occult hernia.

Preperitoneal endoscopic approach is the recommended method in diagnosing and treating occult groin hernias.

A sound knowledge of groin anatomy and thorough preperitoneal inspection of all possible sites for rare groin hernias is needed to diagnose and treat all defects.

A sound knowledge of groin anatomy and thorough preperitoneal inspection of all possible sites for rare groin hernias is needed to diagnose and treat all defects.

No MeSH data available.


Related in: MedlinePlus

The anatomical locations of the groin hernia defects.1: Lateral inguinal hernia; 2: Medial inguinal hernia; 3: Femoral hernia; 4: Prevascular femoral hernia; 5: Retrovascular femoral hernia; 6: Lateral anterior femoral hernia; 7: Lateral posterior femoral hernia; 8: Pectineal hernia; 9: Lacunar hernia; 10: Obturator hernia; 11: Retropsoas hernia; 12: Psoas hernia; 13: Supravesical hernia
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fig0020: The anatomical locations of the groin hernia defects.1: Lateral inguinal hernia; 2: Medial inguinal hernia; 3: Femoral hernia; 4: Prevascular femoral hernia; 5: Retrovascular femoral hernia; 6: Lateral anterior femoral hernia; 7: Lateral posterior femoral hernia; 8: Pectineal hernia; 9: Lacunar hernia; 10: Obturator hernia; 11: Retropsoas hernia; 12: Psoas hernia; 13: Supravesical hernia

Mentions: Femoral hernia has an incidence of 1.8% in elective and 16.7% in emergency groin hernia repairs [4]; it is well described and not considered to be a rare hernia. Femoral hernia is a protrusion of tissue through a hernia defect in the femoral canal, below the inguinal ligament, in the lacuna vasorum, between the vena femoralis and the ligamentum lacunare (Gimbernat) [1]. The incidence of prevascular femoral hernia (Velpeau) is reported to be below 2% of all femoral hernias and 0.77% of all groin hernias. The retrovascular femoral hernia (Serafini) is located below the inguinal ligament, in the lacuna vasorum, immediately posterior to the femoral vessels [5], [6], [7], [8]. The lacuna musculorum hernia herniates through the lacuna musculorum and is divided into two types, the anterior being Hesselbach hernia and the more posterior one Partridge hernia [9], [10]. Lacunar hernia (Laugier, Gimbernat) develops through an opening in the lacunar ligament. The hernia protruding through the pectineal fascia is called Cloquet hernia (Callisen-Cloquet) [11]. The obturator hernia occurs through the obturator canal, which is approximately 2–3 cm long and 1 cm wide. The reported incidence of obturator hernias is 0.07-1.1% of all groin hernias [8], [12]. The psoas hernia herniates through a defect in the psoas muscle caused by traumatic rupture of the muscle. It can present with groin pain without any findings on examination [13]. The retropsoas hernia protrudes directly behind the lateral border of the psoas muscle and presents with chronic groin pain. It is seldom reported with an incidence of 0.09% of all inguinal hernias [8]. Another rare hernia related to the groin is the supravesical hernia that egresses through the supravesical fossa and is divided into internal and external types [14]. The names and anatomical locations of the groin hernia defects are summarized in Table 1 and depicted in Fig. 4. Other rare abdominal wall hernias (Shwalbe, Sciatic, Spigelian, et cetera) are located away from the groin area and will not be discussed in this article.


Multiple concurrent bilateral groin hernias in a single patient; a case report and a review of uncommon groin hernias: A possible source of persistent pain after successful repair
The anatomical locations of the groin hernia defects.1: Lateral inguinal hernia; 2: Medial inguinal hernia; 3: Femoral hernia; 4: Prevascular femoral hernia; 5: Retrovascular femoral hernia; 6: Lateral anterior femoral hernia; 7: Lateral posterior femoral hernia; 8: Pectineal hernia; 9: Lacunar hernia; 10: Obturator hernia; 11: Retropsoas hernia; 12: Psoas hernia; 13: Supravesical hernia
© Copyright Policy - CC BY-NC-ND
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5121153&req=5

fig0020: The anatomical locations of the groin hernia defects.1: Lateral inguinal hernia; 2: Medial inguinal hernia; 3: Femoral hernia; 4: Prevascular femoral hernia; 5: Retrovascular femoral hernia; 6: Lateral anterior femoral hernia; 7: Lateral posterior femoral hernia; 8: Pectineal hernia; 9: Lacunar hernia; 10: Obturator hernia; 11: Retropsoas hernia; 12: Psoas hernia; 13: Supravesical hernia
Mentions: Femoral hernia has an incidence of 1.8% in elective and 16.7% in emergency groin hernia repairs [4]; it is well described and not considered to be a rare hernia. Femoral hernia is a protrusion of tissue through a hernia defect in the femoral canal, below the inguinal ligament, in the lacuna vasorum, between the vena femoralis and the ligamentum lacunare (Gimbernat) [1]. The incidence of prevascular femoral hernia (Velpeau) is reported to be below 2% of all femoral hernias and 0.77% of all groin hernias. The retrovascular femoral hernia (Serafini) is located below the inguinal ligament, in the lacuna vasorum, immediately posterior to the femoral vessels [5], [6], [7], [8]. The lacuna musculorum hernia herniates through the lacuna musculorum and is divided into two types, the anterior being Hesselbach hernia and the more posterior one Partridge hernia [9], [10]. Lacunar hernia (Laugier, Gimbernat) develops through an opening in the lacunar ligament. The hernia protruding through the pectineal fascia is called Cloquet hernia (Callisen-Cloquet) [11]. The obturator hernia occurs through the obturator canal, which is approximately 2–3 cm long and 1 cm wide. The reported incidence of obturator hernias is 0.07-1.1% of all groin hernias [8], [12]. The psoas hernia herniates through a defect in the psoas muscle caused by traumatic rupture of the muscle. It can present with groin pain without any findings on examination [13]. The retropsoas hernia protrudes directly behind the lateral border of the psoas muscle and presents with chronic groin pain. It is seldom reported with an incidence of 0.09% of all inguinal hernias [8]. Another rare hernia related to the groin is the supravesical hernia that egresses through the supravesical fossa and is divided into internal and external types [14]. The names and anatomical locations of the groin hernia defects are summarized in Table 1 and depicted in Fig. 4. Other rare abdominal wall hernias (Shwalbe, Sciatic, Spigelian, et cetera) are located away from the groin area and will not be discussed in this article.

View Article: PubMed Central - PubMed

ABSTRACT

An occult hernia is a hernia where physical examination fails to demonstrate a hernia mass or defect, but a hernia is identified on surgical exploration.

Multiple simultaneous occult hernias can be completely asymptomatic or it may present with unexplained chronic groin or pelvic pain.

MRI is the most accurate preoperative and postoperative diagnostic tool to image an occult hernia.

Preperitoneal endoscopic approach is the recommended method in diagnosing and treating occult groin hernias.

A sound knowledge of groin anatomy and thorough preperitoneal inspection of all possible sites for rare groin hernias is needed to diagnose and treat all defects.

A sound knowledge of groin anatomy and thorough preperitoneal inspection of all possible sites for rare groin hernias is needed to diagnose and treat all defects.

No MeSH data available.


Related in: MedlinePlus