Internal hernia in the medial inguinal fossa with a concurrent indirect inguinal hernia: a case report

A 51-year-old male was presented with abdominal pain and vomiting. Contrast-enhanced computed tomography showed a dilated small intestine with a sac-like appearance in the right lower abdomen. An internal hernia in the inguinal area was found during emergency laparoscopic exploration. The incarcerated small intestine was gently reduced, and the internal hernia sac was located in the right medial inguinal fossa. An indirect inguinal hernia was identified just behind the dissected internal hernia sac. The internal hernia sac was resected, and the indirect inguinal hernia was repaired through a transabdominal preperitoneal approach. The patient had no recurrence of hernia within the 20 months of follow-up after the surgery. This is the first case of an internal hernia in the medial inguinal fossa with a concurrent indirect inguinal hernia. The topographical relationship of these two hernias suggested that an indirect inguinal hernia may cause an internal hernia in the medial inguinal fossa.