Phallo–orchido-atrophy from a huge recurrent indirect inguinal hernia

Abstract

^{Background: A huge indirect inguinal hernia with tiny penis and a gigantic scrotum was observed in a cadaveric male of age 77 years. Clinical record from the hospital  was retrospectively studied with the permission of  his son and the hospital director.}

Objective: To observe the  hernial contents and its effects on the surrounding organs.

Methods: Dissection was carefully done in the inguinal regions, scrotal sac and hernial coverings.

Results: Bilateral indirect inguinal hernia with the predominantly large left side were observed. The scrotum  was enlarged  by a huge left hernial sac containing a long loop of sigmoid colon(8 inches long). This hernial sac put a great pressure on both testes, spermatic cords and pushed them inferiorly to the hernial sac until they were stretchedly thin and atrophied. The penis was pushed to the right and retracted to be tiny (1 inch long). The right hernial sac was incomplete indirect inguinal hernia containing the mesentery. His medical record revealed the history of the left hernial repair 8 years before death but did not report the recurrent time or any clinical sign of phallo-orchido-atrophy.

Conclusion: A case of 77 year old  male cadaver with a huge recurrent indirect inguinal  hernia was studied. The left hernial sac was larger than the right one and extended down to fill up and enlarge the scrotum. The content was a long loop of sigmoid colon (8 inches long). The huge hernial content put a great pressure on both testes, spermatic cords and the penis for a long period of time and consequently causing a phallo-orchido-atrophy.

Keywords: recurrent indirect inguinal hernia, phallo-orchido-atrophy