Interparietal Hernia Associated with Recurrent Inguinal Hernia: A Case Report.

introductionInterparietal hernia (IPH) is a rare subtype of inguinal hernia in which the hernial sac extends between the layers of the abdominal wall musculature. Due to its unusual anatomical location, preoperative diagnosis is often difficult. Reports of adult cases in the English-language literature remain extremely limited. IPH occurring in association with a recurrent inguinal hernia is even rarer. CASE PRESENTATION: A man in his 70s with a history of bilateral inguinal hernia repair presented with abdominal pain and constipation. Contrast-enhanced CT revealed herniation of the sigmoid colon from the internal inguinal ring, with the hernial sac extending cranially between the external and internal oblique muscles. Based on these findings, an interstitial IPH associated with a recurrent inguinal hernia was suspected. Manual reduction was successfully performed, and elective surgery was planned. Subsequently, laparoscopic transabdominal preperitoneal repair (TAPP) was performed. Intraoperative findings confirmed a recurrent inguinal hernia with cranial extension of the hernia sac between the abdominal wall muscle layers. After adequate dissection of the preperitoneal space, a 17 × 12-cm self-gripping mesh (ProGrip) was placed to cover the entire myopectineal orifice. The postoperative course was uneventful, and the patient was discharged on POD 2. No recurrence was observed during the 6-month follow-up period.

conclusionsIPH associated with recurrent inguinal hernia is extremely rare. Careful interpretation of preoperative CT findings may facilitate the accurate recognition of this unusual hernia subtype and assist surgeons in selecting an appropriate surgical strategy. Awareness of this rare condition may improve preoperative assessment and operative planning in patients with atypical inguinal hernias.