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BMJ Case Reports 2012; doi:10.1136/bcr-2012-007919
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Laparosopic management of reduction-en-masse

  1. Anil Kumar2
  1. 1Department of General Surgery, S.C.B Medical College, Cuttack, Odisha, India
  2. 2Department of Surgery, S.C.B Medical College, Cuttack, Odisha, India
  1. Correspondence to Dr Manash Ranjan Sahoo, manash67{at}gmail.com, drmanojsg{at}gmail.com

Summary

Reduction-en-masse of groin hernia is a problem which is rarely encountered by surgeons and in fact in world literature only 200 cases have been recorded till date. Most of the time this complication is overlooked by surgeons. Hence, surgeons repair the hernia leaving the incarcerated bowel inside which might lead to disaster. We report an unusual case of intestinal obstruction due to reduction-en-masse of a groin hernia because of manual reduction by the patient himself 7 days before, which was missed both by the radiologist as well as by the surgeons. It was found out in diagnostic laparoscopy and managed laparoscopically as well, relieving intestinal obstruction. He was discharged with an advice for definitive repair after 3 weeks. To conclude, in patients of groin hernia presenting in any form of intestinal obstruction we have to keep reduction-en-masse in mind and laparoscopy plays an important role in diagnosis and management.

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