# Left-Sided Acutely Irreducible Terminal Ileum Hernia With Cecum, Appendix, and Sliding Sigmoid: Case Report and Review of the Literature

## TL;DR

A rare case of a left-sided hernia containing the cecum, appendix, and sigmoid colon is reported, highlighting the challenges in diagnosis and the need for surgery.

## Contribution

This case report adds to the literature on rare hernia presentations involving multiple organs in the left inguinal hernia sac.

## Key findings

- A 45-year-old male presented with a left-sided hernia containing the cecum, terminal ileum, appendix, and sliding sigmoid colon.
- Such hernias are rare and often present with nonspecific symptoms, requiring surgical intervention for accurate diagnosis.
- The case emphasizes the importance of considering unusual hernia content during clinical evaluation.

## Abstract

Amyand's hernia is the presence of the vermiform appendix within the inguinal hernia sac, while a sliding hernia involves the herniation of a retroperitoneal organ outside the abdominal cavity. The hernia sac can contain various intraabdominal organs, including the small bowel, cecum, appendix, omentum, or ovary and fallopian tube. A hernial sac containing the appendix on the left side is rare, and the presence of other organs in combination is also uncommon. We are presenting a case of a 45-year-old male who presented with irreducible left inguinal swelling and obstructing symptoms. Interestingly, a large left indirect hernia sac was seen intraoperatively containing incarcerated cecum, terminal ileum, appendix, and sliding sigmoid colon. Left-sided incarcerated terminal ileum, cecum, appendix, and sliding hernia can be challenging because the symptoms are often nonspecific. However, surgery is often the only way to definitively diagnose these types of hernia.