inguinal swelling and uterine prolapse management

65yr lady fit, known reducible swellings in rt inguinal region and per vagina since decades, presented with features of acute intestinal obstruction since 3days along with irreducible rt inguinal region swelling. o/e dehydration, afebrile, stable, irreducible tender Rt inguinal swelling and uterine prolapse. Please opine your Surgical approach managing.

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Irreducible hernia in inguinal region in females may be due to A Obstructed inguinal hernia B obstructed femoral hernia Vaginal protrusion may be prolapsed uterus USG may be done to distinguish bet inguinal and femoralb hernia Repair should be in both the cases urgently , as the obstruction for 3 days there may be changes with the vascularity of the intestine measure to be taken accordingly.

Thanks Dr Pranab Bera.
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Seems to be Obstructed right inguinal hernia with uterine prolapse. There is chance of it being femoral hernia but management remains the same. CECT abdomen followed by surgery for both pathologies in one sitting. As already obstructed, mesh should not be used. Consent for resection-anastomosis as duration is 3 days and swelling is tender.

Its a case of right inguinal hernia with prolapse uterus but chances of femoral hernia needs to be investigated.

As the Patient’s condition is stable I dont expect gangrene of bowel! Its irreducible inguinal hernia! Herniorrhaphy should be done! There is Partial Uterine Prolapse! Fothergills Operation and Perineal Repair is the Treatment of choice! I prefer doing it at a later stage, till then a ring can be kept after reducing Uterus in osition!

Welcome back to curofy sir. your cases are always helpful. Please be regular on curofy & keep posting

Dr. Suresh Chandra Annu
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Right inguinal hernia with uterine prolapse but chance of it being femoral hernia

Dear friends, what incision is preferred here? And repair?

I am agree with@Dr. Mrinal Kantil Pal Sir, And@Dr. Pranay Gourav Sir.

Umblical hurnea

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