PMC6563333_01
Showing Inferior epigastric artery traversing superficial course in posterior wall of inguinal canal, with two direct sacs, S1 & S2 seen on either side of IEA.
gr1.jpg
PMC6563333_01_gr1.jpg
fig0005
Inferior epigastric artery was traversing superficially on posterior wall, midway between the deep and superficial ring (mid point of inguinal canal) with visible pulsations present [Fig. 1]. A direct component of hernia was seen protruding, one lateral to IEA and another medial to IEA with no cross fluctuation present and each having individual cough expansibility and reducibility [S1 & S2, Fig. 1].
Showing indirect sacs, an unopened sac (A) and the two sacs (B & C) abutting each other with contents.
gr2.jpg
PMC6563333_01_gr2.jpg
fig0010
There was one bubonocele and two funicular type of indirect hernia present [Fig. 2].
Showing three adjacent indirect sacs adjacent to each other, one unopened sac (A), two indirect sacs (B & C).
gr3.jpg
PMC6563333_01_gr3.jpg
fig0015
Third sac with omentum as a content was mobilised from cord and was abutting posterior wall of second sac, Sac B [Fig. 3]. Transfixation with ligation of each sac was done individually and released back into the peritoneal cavity [Fig. 4].
Showing opened all indirect sacs, A, B and C.
gr4.jpg
PMC6563333_01_gr4.jpg
fig0020
Third sac with omentum as a content was mobilised from cord and was abutting posterior wall of second sac, Sac B [Fig. 3]. Transfixation with ligation of each sac was done individually and released back into the peritoneal cavity [Fig. 4].