Asian Journal of Case Reports in Surgery

Inguinal hernia repair is one of the most common surgeries performed overall. However, sliding variety is rare with an incidence of less than 5% of all inguinal hernia. Intestinal obstruction is extremely rare with an incidence of 12% of all sliding types of inguinal hernia.

We report a case of 66-year-old male presenting with the history of inability to pass stools, flatus, and painful, large swelling in the right inguino-scrotal region. On right inguinal exploration, an obstructed direct inguinal hernia of sliding variety containing ileum, caecum, and ascending colon as contents with caecum and ascending colon forming the posterior wall of the sac was found. The contents were reduced; posterior wall defect closure along with meshplasty was performed.

Direct inguinal hernia of sliding variety is a rare encounter and such a case presenting in obstruction, is an extremely rare condition of its kind. Care must be taken to prevent inadvertent injury to the bowel. The laparoscopic approach can be used nowadays, if the condition is diagnosed early.