At open inguinal hernia repair, a surgeon finds two separate hernial sacs on the same side: one emerging through the deep ring lateral to the inferior epigastric vessels, and another bulging through the weakened posterior wall medial to them. What is this combination called?

• A Cooper's hernia
• B Double-crural femoral hernia
• C Saddlebag (pantaloon) hernia ✓
• D Divarication of the recti with true hernia

Explanation

C pantaloon or saddlebag hernia consists of simultaneous direct and indirect sacs straddling the inferior epigastric vessels like the two legs of a pair of trousers. It matters surgically because repairing only the obvious indirect sac leaves the direct component behind, a recognized cause of early recurrence. Cooper's hernia refers to a femoral hernia with two sacs, one beside the vessels and one tracking up into the retroperitoneum. Recognizing both sacs dictates mesh placement covering the whole myopectineal orifice.

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.