Repair of a giant inguinoscrotal hernia

We present a case of a long-standing, giant inguinoscrotal hernia extending to the patient's knees, complicated by intestinal obstruction. Initial man agement involved conservative treatment of the intestinal obstruction and o ptimising the patient's general condition. Surgical treatment included debu lking the contents of the hernia sac by performing a right hemicolectomy an d a small bowel resection, and reconstruction of the abdominal wall using M arlex mesh and a tensor fasciae latae flap. Although abdominal wall reconst ruction for massive ventral or incisional herniae is well reported, inguino scrotal herniae of this magnitude are much rarer and pose additional proble ms, which are discussed in this paper. (C) 2000 The British Association of Plastic Surgeons.