Concomitant incarcerated right direct inguinal hernia and right femoral hernia in a male patient: a case report.

Abstract

Concomitant indirect inguinal and femoral hernias on the same side are rare and often undetected preoperatively, especially when complicated by incarceration. We report this case to highlight its rarity and importance in the clinical decision process. An 83-year-old male with asthma presented with right inguinal pain and vomiting. The workup revealed a right direct inguinal hernia with small bowel obstruction. During surgery, a right direct inguinal hernia with a non-inflamed appendix (Amyand's hernia) and a right femoral hernia with a small bowel segment (Richter's hernia) were found. Both hernias were repaired with mesh. Concomitant right indirect inguinal and femoral hernias are challenging to diagnose preoperatively, especially in males. Early surgical intervention, aided by high suspicion and anatomical knowledge, prevents complications. This case demonstrates successful treatment with open mesh repair of both hernias.