Computerized radiography of incarcerated ‘Fatty Hernia’

A 71-year-old male reported the presence of a left scrotal mass for “two to three years.” Chronic systemic problems included diabetes mellitus II, gastric reflux, obesity, obstructive pulmonary disease, congestive heart failure, and groin lymphedema. Physical examination showed an obese man (BMI 40.1) who moved with difficulty and had exertional dyspnea. Penile and left scrotal skin were swollen. A large, soft, non-tender mass filled his left inguinal canal and scrotum. This could be partially reduced with the patient supine. Ultrasound examination of his groin showed groin skin edema and a soft tissue mass in the scrotum. Computed tomography showed a 6x8 cm fat-containing hernia extending into the scrotum. The left kidney was ptotic (Figures 1 and 2). The hernia’s contents did not seem to be at risk for strangulation because the hernia was very broad-based. For this reason and the patient’s high operative risk, surgical therapy was not recommended.