title: False reduction of an inguinal hernia treated by Kugel patch repair via an anterior approach.
abstract: BACKGROUND
  Reduction en masse of inguinal hernia is a rare condition following manual reduction of an unrecognized incarcerated inguinal hernia. The preoperative diagnosis and surgical treatment via an inguinal approach has been considered difficult.
  
  
  METHODS
  A 59-year-old man with lower abdominal pain was presented to our hospital. He was diagnosed reduction en masse of an inguinal hernia based on his CT findings which showed the presence a pre-peritoneal hernia sac containing the small bowel. An emergency operation via an anterior approach was performed and we found a hernial sac containing an incarcerated small bowel at the cranial and internal sides of the internal inguinal ring. Opening of the hernial sac revealed necrosis of the incarcerated small bowel and bowel resection was performed. Kugel patch was inserted into the pre-peritoneal space and the patient made an uneventful recovery.
  
  
  CONCLUSIONS
  When it is accurately diagnosed, reduction en masse of an inguinal hernia can be treated with direct Kugel repair via an anterior approach.
authors: Department of Surgery, Asahi General Hospital, 1326 I, Asahi-shi, Chiba, 289-2511, Japan. yn708@jichi.ac.jp.
authors: Naoya
authors: N
authors: Yamada
authors: Department of Surgery, Asahi General Hospital, 1326 I, Asahi-shi, Chiba, 289-2511, Japan. atsuakai@gmail.com.
authors: Atsushi
authors: A
authors: Akai
authors: Department of Surgery, Asahi General Hospital, 1326 I, Asahi-shi, Chiba, 289-2511, Japan. a.seo0424@gmail.com.
authors: Akihiko
authors: A
authors: Seo
authors: Department of Surgery, Asahi General Hospital, 1326 I, Asahi-shi, Chiba, 289-2511, Japan. nomura@asahi.chiba.jp.
authors: Yukihiro
authors: Y
authors: Nomura
authors: Department of Surgery, Asahi General Hospital, 1326 I, Asahi-shi, Chiba, 289-2511, Japan. nbtanaka@hospital.asahi.chiba.jp.
authors: Nobutaka
authors: N
authors: Tanaka
mesh_terms: D006552:Hernia, Inguinal / Q000175:diagnosis / Q000601:surgery*; D059685:Herniorrhaphy / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged
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