A 60-year-old farmer with a long-standing left groin hernia notices the swelling does not fully reduce even when he lies down. At operation, part of the wall of the hernial sac is formed by the sigmoid colon itself. This is best described as:

• A Maydl's hernia
• B Interparietal hernia
• C Richter's hernia
• D Sliding (extrasaccal) hernia ✓

Explanation

In a sliding hernia, a retroperitoneal viscus such as sigmoid colon, caecum or bladder forms part of the wall of the sac, so the sac cannot be completely separated from the bowel during repair. The sac must be opened away from the viscus and the organ returned to the abdomen before repair. Richter's hernia involves only the anti-mesenteric border, and Maydl's involves two loops, so both are anatomically different.

Reference: Sabiston Textbook of Surgery, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.