Para-inguinal hernia; presentation, diagnosis and surgical treatment, a case report

INTRODUCTION: Para-inguinal, or peri-inguinal, hernias are a rare type of hernia of the inguinal region that present in a similar fashion to but do not anatomically correspond to inguinal or femoral hernia pathologies. Surgeons should be aware of this rare pathology, diagnostic imaging and surgical treatment approaches including minimally invasive techniques. In this paper, we discuss the different groin region hernias and describe the first case reported of a successful TEP repair of a para-inguinal hernia. PRESENTATION OF THE CASE: 62-year-old-female who presented to the clinic with symptomatic large right groin bulge. Examination revealed a large incarcerated right inguinal hernia above the inguinal ligament without strangulation. Intraoperatively, it was found that she had a fat containing incarcerated right para-inguinal hernia with a defect just superior and lateral to the deep inguinal ring. She underwent a successful laparoscopic repair with mesh utilizing Total Extraperitoneal approach (TEP). DISCUSSION: This a case report discussing a rare groin hernia entity called Para (Peri) Inguinal hernia. This hernia presents in a very similar fashion as inguinal hernias but the defect is separate from the known inguinal or ventral hernia defects. Presentation, Diagnosis and Surgical treatment approach is discussed in this case report. CONCLUSION: Para-inguinal hernias are a rare hernia type of the groin. They might be challenging to differentiate from inguinal hernias clinically and might be diagnosed on imaging or intraoperatively. Repairing them utilizing minimally invasive inguinal hernia repair approaches can be completed successfully.