A 60-year-old man undergoes open repair of a large right indirect inguinal hernia. At operation the surgeon notes that part of the posterior wall of the hernial sac is formed by the caecum itself, with no true peritoneal covering over it. What is this type of hernia called?

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

Explanation

In a sliding hernia a retroperitoneal organ, classically the caecum on the right or sigmoid colon on the left, protrudes through the abdominal wall and forms part of the wall of the sac, so it lacks a complete peritoneal coat. The danger at surgery is injuring the bowel while opening the sac. Richter's contains only a knuckle of anti-mesenteric border, Littre's contains a Meckel diverticulum, and Maydl's contains two loops with a middle loop inside the abdomen.

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.