A strangulated inguinal hernia is explored. The surgeon finds two separate loops of ileum within the sac, connected by a third loop that remains inside the abdominal cavity. Which statement about this entity is correct?

• A It is called a Littre's hernia, and the strangulated segment is always Meckel's diverticulum
• B It is called a Maydl's hernia, and the strangulated loop typically lies within the peritoneal cavity ✓
• C It is called a Richter's hernia, and only the antimesenteric border is trapped
• D It is called a sliding hernia, and the sac wall is formed by bowel

Explanation

Maydl's hernia is a retrograde (W-shaped) hernia in which two loops occupy the sac while the connecting middle loop lies free in the abdomen. Because the constricted middle loop is intra-abdominal, it may strangulate and even perforate while the sac contents look viable, so the surgeon must always draw out and inspect the interior loop. Littre's hernia contains Meckel's diverticulum and Richter's hernia traps only part of the circumference, neither of which matches the finding described.

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.