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Figure 1

From: An atypical lateral hernia and concomitant inguinal and umbilical hernias in a patient with polycystic kidney disease and an intracranial aneurysm – a combined approach of clinical and radiological investigation, endoscopic hernia repair, and anatomical cadaver model documentation and a systematic review of the literature

Figure 1

Pre-operative localization of the hernia using (a) ultrasound and (b,c) CT. (a) Hernia on the right side (orange arrow) movable, atypically lateral position. Red arrow points to the iliopsoas muscle. (b) Coronal CT scan demonstrates direct inguinal hernias on both sides (orange asterisks) within the transversal fascia as well as the very lateral inguinal hernia with adipose tissue and small intestine (orange arrow) lateral to the spermatic cord (yellow arrow) on the right side. Note enlarged polycystic kidneys. (c) Horizontal CT scan reveals the position of the lateral hernia (orange arrow) latero-dorsal to lateral abdominal wall muscles (red asterisk), in particular internal oblique and transversus abdominalis muscles, to the inferior epigastric vessels (turquoise arrow), and the inguinal ligament, and lateral to the spermatic cord (yellow arrow).

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