Bilateral large inguinal hernia with buried penis–a rare case report

A 7-year-old child reported with swelling in the bilateral inguinoscrotal region. Parents have noticed swelling just after the 6 months from birth. There was also a complaint of penile shortening as far as its size is concerned. No other complaints were present. The vitals were stable. On local examination, bilateral inguino-scrotal swelling was present of a size about 8 x 6 cm on both sides, firm in consistency, non– tender and the skin was normal in appearance (figure-1). Swelling was reducible on lying down and cough impulse was present (figure-2). The penis was buried inside and the testis was felt separately. The incision was made over the skin crease, opened in layers and the cord was identified. Then sac was identified and separated from the cord. Contents were small bowel loops, which were reduced and the sac was transfixed with Vicryl 3-0. Herniotomy was done. The same procedure was done to the other side. The child was discharged in a satisfactory condition. The child is doing well in the follow up period of 6 months. Inguinal hernia is one of the most common pediatric surgical problems and when treated early and appropriately it is associated with negligible morbidity and Fig. 1. Large bilateral inguinal hernia and buried penis Fig. 2. After the reduction of the hernia the penis was normal