Botox and Pneumoperitoneum in the Management of Giant Inguinoscrotal Hernia: A Case Report.

Abstract

Introduction: Giant inguinoscrotal hernia is an unusual and significantly challenging condition in terms of surgical treatment. The forced reduction of the viscera leads to an increase in intraabdominal pressure, which can result in compartment syndrome, a serious condition that endangers the patient's life. Throughout history, various techniques have been described for its repair. Case Report: We present the case of a 66-year-old male patient with bilateral inguinoscrotal hernia with loss of domain, containing intestinal and omental contents, treated with the application of Botulinum Toxin A (BTA) as an adjuvant, followed by Progressive Pneumoperitoneum (PPP), and subsequent abdominal defect repair with hernioplasty according to the technique proposed by Lichtenstein. The patient had an uncomplicated recovery. Conclusion: The combined or separate application of these techniques represents an effective preoperative tool for addressing hernias with loss of domain, demonstrating themselves to be sufficiently safe, well-tolerated strategies with a low rate of complications or recurrence.