An alternative approach for management of the congenital giant inguinal hernia in neonates

Whereas inguinal hernias are commonly encountered in the neonatal population, giant hernias containing the entire small bowel and with complete inguinal floor disruption are significantly less common. These cases present clinical and technical challenges with the obliteration of normal anatomy and an attenuation of the expected abdominal domain. There is a scant literature available describing these hernias or their management in neonates. In this case report, we describe a neonate who presented with a giant unilateral inguinal scrotal hernia complicated by in utero perforation. This was managed by open herniorrhaphy, orchidopexy, and diagnostic laparoscopy.