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Evangelos P. Misiakos, MD; Theodore Liakakos, MD; Urania Preza, MD; Constantinos Fotiadis, MD; Anastasios Macheras, MD

Arch Surg. 2009;144(6):589.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

INTRODUCTION

A 72-year-old patient presented with a bulging right scrotal hernia that caused worsening discomfort. The patient was a smoker and had hypertension that was being treated by medication. The hernia was repaired laparoscopically using the transabdominal preperitoneal polypropylene (TAPP) approach. At surgery the large sac of a direct hernia (with a small bowel loop within it) and the smaller sac of an indirect hernia were found. The hernia sac and its contents were reduced, and a piece of polypropylene mesh measuring 12 cm x 13 cm was placed preperitoneally and stabilized with tacks to the pubic symphysis and the pectineal ligament; thereafter, it was covered with a peritoneal patch.

Two months later the patient presented with a firm round mass, which was slightly tender upon palpation, in the area of the right internal inguinal . . . [Full Text of this Article]

What Is the Diagnosis?

Author Affiliations: Third Department of Surgery, University of Athens School of Medicine, Attikon University Hospital, Athens, Greece.

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Arch Surg. 2009;144(6):590.
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