(18,19) The incidence of recurrence further depends upon the technique used for placing the mesh and it should therefore be placed properly beneath the external oblique aponeurosis and above the posterior wall of inguinal canal
with minimal folding or wrinkling of the mesh around the spermatic cord.
Inguinal rupture is protrusion of viscera into the subcutaneous tissue of the inguinal canal
or scrotum through a rent in the peritoneum and musculature adjacent to the vaginal ring.
Our patient presented with ambiguous genitalia, with a phallus-like midline structure of 1.5 cm, hypospadias, perineal blind vaginal pouch, posterior labioscrotal fusion, while both his testes were localized in the inguinal canals
(Sinnecker type 2 to 3).
On ultrasonography, nonpalpable testes were localized at various sites as intraabdominally (3 cm proximal to deep inguinal ring), near deep inguinal ring, in inguinal canal
, and in superficial inguinal pouch and could not be localized in 11 (33.33%), 9 (27.2%), 3 (9%), 3 (9%), and 7 (21.2%) cases, respectively.
As the sensitivity of the US against testicular torsion is as high as 88.9-100% [1, 2] and the US in this case showed clear blood flow into both testes, we had to rule out another disease that required emergent surgery--incarcerated intestine or omentum into the inguinal canal
. Even the highest sensitivity of the US for incarcerated inguinal hernia is 91% , and thus, the possibility of an incarcerated hernia could not be eliminated.
In the cases reported, as in our own experience, there was a noticeable enlargement of the hemiscrotum extending to the inguinal canal
. In most cases there was a thickened spermatic cord and a palpable scrotal mass, but the consistency of the mass differed from fluctuant to firm [20, 24].
Considering that at our institution all inguinal hernia sacs are examined microscopically, this shows the rarity of liposarcomas in the inguinal canal
. Montgomery E.
Here, we have shown that for selected patients, without severe intraabdominal injuries or gross contamination, it is possible to perform the abdominal wall and inguinal canal
reconstruction with a tension-free, modified Stoppa mesh technique and reduce the pelvis simultaneously in the acute setting with durable results.
Caption: Figure 2: CT image demonstrates narrowing of bilateral dilated ureters entering the inguinal canal
In both groups, the surgeon incised the skin and subcutaneous tissue of the lower part of the abdomen and then the fascia of Scarpa and the roof of the inguinal canal
. The first group was assigned to the classic method; after reinforcement of the posterior wall of the inguinal canal
, the Mersilene mesh (7.5 x 10 cm) was placed and fixed using Round nylon stitch 3/0 to the edges of the defect or weakness in the posterior wall.
This process is androgen-dependent and relies on testosterone and androgen receptors to orchestrate descent of the testis from the inguinal canal
to the scrotum.
Skin incisions of 3 cm were opened in the inguinal region over inguinal canal
subcutaneous tissue, Scarp fascia and oblique external muscle fascia (Fig.