At operation for a right inguinal hernia, the surgeon finds two separate peritoneal sacs on the same side, one passing lateral to the inferior epigastric vessels through the deep ring and the other passing directly through Hesselbach's triangle medial to them. What is this configuration called?

• A Sliding hernia
• B Saddlebag (pantaloon) hernia ✓
• C Recurrent hernia
• D Femoral hernia with a diverticular sac

Explanation

B saddlebag or pantaloon hernia consists of combined direct and indirect sacs straddling the inferior epigastric vessels like a pair of trousers hung over them. It matters operatively because repairing only the obvious sac leaves the second sac behind and guarantees recurrence, so both components must be identified and dealt with. B sliding hernia has a viscus forming the sac wall, and a recurrent hernia implies previous repair, neither of which fits the description given.

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.