| Popis: |
Maydl's hernia is a very rare type of a hernia and at times presents as a deceptive condition in a strangulated hernia. There is a paucity of reference to this condition in the literature though it is mentioned in few standard textbooks with little detail. It is also known by other names – “Hernia in W,” “double loop hernia” and “retrograde strangulation.” The Maydl's hernia appears to describe the only three-dimensional spatial anatomical relation of gut loops without reflection of etiology whether a hernia is sliding or not. This arrangement may be present in all types of inguinal hernias as and when hernia ring offers passage of sufficient length of gut through it. This happens when there is an alternate double entry and double exit of gut loops into the hernia sac from a peritoneal cavity that is Entry, Exit-Entry, Exit that may be remembered as a 4E sequence of gut loops. Though, all the gut loops of “W” may be strangulated, but intra-peritoneal loops are first to strangulate. |
