Patient refered for scrotal mass workup, patient with 1 month history of left scrotal mass with no pain with prior left inguinal mass.
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There´s a gigantic left inguinoscrotal hernia with mesenteric fat and intestinal component asociated, left and right testicles are normal in ultrasound examination (not shown).
There's an acute abscess formation in the left scrotal wall.
Also a right direct hernia is shown with partial vesical wall component.
Direct inguinal hernias result from weakening of the transversalis fascia in the Hesselbach triangle.
This type of hernia is termed direct as the hernial sac directly protrudes through the inguinal wall, they usually extend into the scrotum.
As in this case the hernial sac becomes incarcerated with the augmented risk of necrosis or bowel obstruction.