title: Emergency repair of giant inguinoscrotal hernia in a septic patient.
abstract: BACKGROUND
  Giant inguinoscrotal hernias are rare but still exist even in developed countries. Although accompanied by a higher perioperative mortality, an elective surgical approach should be undertaken. In critically ill patients, however, the surgical intervention requires specific demands.
  
  
  METHODS
  We report a case of a 45-year-old man who was referred to the hospital after perforation of the hernia with concomitant peritonitis and sepsis.
  
  
  RESULTS
  After initial stabilization of the patient, a subtotal colectomy and a partial small bowl resection was performed. In a second step after stabilization of organ functions, the hernia sac was resected, and the abdominal cavity was reconstructed. The patient was discharged and is doing well until today but still refuses any plastic surgery.
  
  
  CONCLUSIONS
  Resection of giant inguinoscrotal hernia is feasible even in patients being administered in an emergency setting. Especially in case of an intra-abdominal infection, intestinal resection is the therapy of choice to allow the reconstruction of the abdominal cavity. A two-step approach should be considered to allow a successful recovery.
authors.affiliation: Department of General and Visceral Surgery, University Medical Center Göttingen, Göttingen, Germany. j.gaedcke@gmail.com
authors.forename: J
authors.initials: J
authors.lastname: Gaedcke
authors.forename: P
authors.initials: P
authors.lastname: Schüler
authors.forename: J
authors.initials: J
authors.lastname: Brinker
authors.forename: M
authors.initials: M
authors.lastname: Quintel
authors.forename: M
authors.initials: M
authors.lastname: Ghadimi
mesh_terms: D004638:Emergency Treatment; D006552:Hernia, Inguinal / Q000150:complications* / Q000473:pathology / Q000601:surgery*; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012611:Scrotum; D018805:Sepsis / Q000150:complications*