An elderly man undergoes surgery for a large left inguinal hernia. The surgeon finds that part of the posterior wall of the hernia sac is formed by sigmoid colon with its mesentery, so the colon cannot be simply reduced from within the sac. This is an example of:

• A Maydl's hernia
• B Sliding (excentric) hernia ✓
• C Littre's hernia
• D Richter's hernia

Explanation

A sliding hernia is one in which a retroperitoneal organ, typically the caecum on the right or the sigmoid colon on the left, forms part of the wall of the sac because it has never been enclosed by peritoneum. The sac must be opened away from the viscus and repaired carefully to avoid bowel injury. Littre's contains Meckel's diverticulum, Richter's contains only the antimesenteric border of bowel, and Maydl's is a retrograde double-loop hernia.

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.