Background
False reduction of an inguinal hernia, also known as "reduction en masse", is an extremely rare condition of an incarcerated inguinal hernia in which a hernia sac reduces into the preperitoneal space with its contents, but the retained bowel remains incarcerated and the obstruction persists. Although the condition requires urgent surgical treatment, an accurate preoperative diagnosis has been difficult and a delay in diagnosis sometimes occurs because the inguinal hernia appears to be reduced.
Surgical treatment for reduction en masse of an inguinal hernia consists of relief of strangulation and hernia repair. In many reported cases of reduction en masse, exploratory laparotomy or laparoscopy was used because patients were preoperatively diagnosed with strangulated ileus of unknown origin. In those cases, reduction en masse was diagnosed on the basis of intraoperative findings.
However, recognition of cases and recent utilization of computed tomography (CT) imaging have made progress in accurate preoperative diagnosis of reduction en masse. Accordingly, we herein report our experience of reduction en masse of inguinal hernia which was treated by Kugel patch repair via an anterior approach.