Three-stage repair of a giant inguinal hernia in Sierra Leone: A management technique for low-resource settings

Abstract

In this report we discuss the clinical management of a giant inguinal hernia (GIH) in Sierra Leone where surgical resources are severely limited. Though possibly not appropriate for more heavily resourced areas, a three-stage repair proved to be effective and safe for the management of this condition. Careful explanation, good planning and staged operations may be needed for the repair of GIH in low resource settings and we therefore encourage that they be treated by experienced personnel who are able to secure follow up of the patient. The management of GIH is complicated by the potential of abdominal compartment syndrome and respiratory distress if the hernia is reduced suddenly.

© JSCR.

Figures

Fig 1

Giant inguinal hernia with ulceration pre-op.

Fig 2

Giant inguinal hernia after Stage I: Resection of ulcer and surrounding scrotal skin, partial reduction of hernia sac contents.

Fig 3

Giant inguinal hernia after Stage II: Partial reduction of hernia sac contents and resection of scrotal skin

Fig 4

Giant inguinal hernia after Stage III: Bowel resection, ileo-colic anastomosis, hernia repair and resection of scrotal skin)