Concomitant management of a large abdominal aortic aneurysm and a giant incarcerated inguinal hernia.
The optimal therapeutic approach to a patient who has a large incarcerated inguinal hernia and an abdominal aortic aneurysm (AAA) of significant size is controversial. Here we report a case of a patient who presented with a giant incarcerated inguinal hernia who was found to have an 8-cm AAA. Three surgical options were considered: (1) perform open AAA repair first, followed by hernia repair a few weeks later to allow for recovery, (2) perform hernia repair first followed by AAA repair a few weeks later, or (3) perform both simultaneously as a combination procedure. We successfully performed hernia repair first, followed by open AAA repair as a separate procedure at a later date. We believe that a two-stage approach, performing hernia repair first, is the safest approach to surgical repair of an incarcerated hernia in a patient with an asymptomatic AAA that requires open repair.
Konig
G
G
University of Pittsburgh School of Medicine, 3550 Terrace Street, Pittsburgh, PA 3550, USA.
Goldstein
S L
SL
Gupta
N
N
D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D006552:Hernia, Inguinal / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D011859:Radiography; D012611:Scrotum / Q000000981:diagnostic imaging