At open inguinal hernia surgery, a surgeon finds a direct hernial bulge through Hesselbach's triangle and, after mobilising the cord, also finds an indirect sac emerging lateral to the inferior epigastric vessels through the same groin. Both components share a single presentation as a saddle-shaped swelling. What is this combination called?

• A Interparietal (interstitial) hernia
• B Cooper's hernia
• C Pantaloon (saddlebag) hernia ✓
• D Giant inguinoscrotal hernia

Explanation

C pantaloon or saddlebag hernia consists of direct and indirect components straddling the inferior epigastric vessels, resembling the two legs of a pair of trousers. It corresponds to Gilbert type VI. Recognising it matters because repairing only the visible component leaves the other untreated and guarantees recurrence; the preperitoneal approach used in laparoscopic repair handles both components naturally. Cooper's hernia is a femoral hernia with two saccules, and interparietal hernia tracks between abdominal wall layers.

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.