A 60-year-old man undergoes open repair of a left inguinal hernia. The surgeon finds that the posterior wall of the hernial sac is formed by the sigmoid colon itself, which cannot be separated from the sac. Which statement about this hernia is correct?

• A It is always reducible because the contents are retroperitoneal
• B The sac must be completely excised before repair
• C The caecum is the commonest content on the left side
• D It is more common on the left side than the right side ✓

Explanation

A sliding hernia contains a retroperitoneal organ that forms part of the wall of the sac. On the left side the sigmoid colon is the usual content, while on the right side the caecum predominates, so left-sided sliding hernias are more common. Because the viscus forms the sac wall, the sac must never be forcibly dissected or excised; the repair is done with the organ reduced intraperitoneally or left in situ with a preperitoneal mesh.

Reference: Bailey and Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.