# Giant Inguinoscrotal Hernia With Loss of Domain in a Patient With Alcoholic Liver Cirrhosis: A Case Report

## TL;DR

A 47-year-old man with liver cirrhosis developed a complex giant hernia, successfully treated with a tailored surgical approach.

## Contribution

Presents a rare case of giant inguinoscrotal hernia in a cirrhotic patient with successful treatment using a multidisciplinary approach.

## Key findings

- The patient had a giant hernia containing colon and small bowel due to alcoholic liver cirrhosis.
- Preoperative preparation with pneumoperitoneum and botulinum toxin improved surgical outcomes.
- Elective hernioplasty led to a favorable clinical result in a high-risk patient.

## Abstract

Inguinal hernias are commonly seen in clinical settings and may occasionally present in complex forms that pose significant surgical challenges. In its giant inguinoscrotal form with loss of domain, it presents a significant surgical challenge. These hernias are associated with considerable risks, particularly due to potential cardiorespiratory complications during reintegration of the intra-abdominal organs. The complexity increases in patients with comorbidities such as liver cirrhosis. We present the case of a 47-year-old male patient with alcoholic liver cirrhosis who developed a giant inguinoscrotal hernia containing loops of colon and small bowel. Treatment involved preoperative preparation with progressive pneumoperitoneum and botulinum toxin administration, followed by elective hernioplasty, which resulted in a favorable clinical outcome. This case underscores the importance of an individualized, multidisciplinary approach to optimize surgical outcomes in patients with complex medical conditions.