During surgery for an incarcerated inguinal hernia, two loops of ileum are found inside the sac, but the segment of bowel connecting them lies entirely within the abdominal cavity. The connecting loop appears dusky and non-viable. This hernia is classified as:

• A Maydl's hernia ✓
• B Sliding hernia
• C Richter's hernia
• D Intussuscepted hernia

Explanation

Maydl's hernia, also called the hernia-en-W or retrograde hernia, contains two loops of bowel in the sac connected by an intermediate loop that remains inside the peritoneal cavity. Because the constricted neck compresses the mesentery of this intra-abdominal loop, strangulation begins in bowel that the surgeon cannot see unless laparotomy or intra-abdominal inspection is performed. This hidden gangrenous loop is the danger that distinguishes Maydl's from a simple two-loop incarceration.

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.