Abstract
Aim: is to emphasize inguinal mega hernia management with resection of the cord.
A case of 60 years blind male patient presented to the casualty department at 20 December 2008, complaining of two weeks history of complicated inguinal hernia, diagnosed to be giant, neglected, strangulated, Lt. sided complete oblique inguinal hernia, enterocele, with patches of scrotal skin gangrene scattered over it, other hernia orifices are intact, no history of previous surgery of any kind, with multiple co-morbidity, and somewhat week abdominal musculature.
Methods: Bad general condition control followed by urgent surgery through inguino-scrotal and abdominal incisions, resection anastomosis of the strangulated intestine, Lt. Orchidectomy, and obliteration repair of the Lt. inguinal canal. Gangrenous infected scrotal skin resection for delayed primary closure.
Results: Postoperative ICU follow up treatment, repeated scrotal daily dressing, and care of associated co-morbidity. Lastly delayed primary scrotal closure was done with discharged after12 day.
Conclusion: In spite of the advancement of medical care and hospitals, still neglected cases may be seen in surprisingly huge sizes, usually complicated, that is challenging to the surgeon. Unilateral orchidectomy still may be a solution in such old feeble patient, in such infected field, with obliteration repair of inguinal canal.