During surgery for a strangulated inguinal hernia, the surgeon delivers a hernial sac containing two separate loops of small bowel connected within the abdomen by a third intervening loop. The strangulated segment is the loop inside the abdomen between the two sac loops. This entity is called:

• A Maydl's hernia ✓
• B Richter's hernia
• C Littre's hernia
• D Cooper's hernia

Explanation

Maydl's hernia is a 'W' shaped hernia in which two limbs of bowel lie in the sac while the middle connecting loop remains intra-abdominal, and it is this hidden middle loop that becomes strangulated and gangrenous. The danger is that the surgeon may find viable-looking bowel in the sac and miss the necrotic intra-abdominal segment, so the whole length must be inspected. Richter's and Littre's involve a single structure in the sac.

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.