Chronic expanding hematoma mimicking seroma, following a totally extraperitoneal approach for inguinal hernia: a case report

Chronic expanding hematoma (CEH) mimicking seroma following inguinal hernia surgery has not been reported previously. A 78-year-old man underwent laparoscopic repair of a left direct hernia via a totally extraperitoneal approach. He was discharged 2 days after surgery without any complications. Two weeks later, he complained of left inguinal bulging without pain. We considered seroma and decided to observe the patient for 1 month. However, the cyst did not change in size. Additional cyst aspiration and drainage attempts were unsuccessful. Three months after the initial surgery, we performed a second surgery (resection of the cyst) because conservative therapies were ineffective. The resected cyst was pathologically diagnosed as a CEH. The postoperative course was uneventful, and no recurrence was observed. Complete excision of a CEH is mandatory because aspiration and drainage cannot prevent recurrence.