warning: I’m linking to an extremely graphic image, but the story kind of has a happy ending, kind of…?

This is one of those things. It’s almost laughable. When I was googling ‘right inguinal hernia’ the other day I saw a guy who looked like he had been almost completely disemboweled (and that’s the second time I’ve used that word recently, because some predatory animal has been prowling in the woods and it killed something on the bike path a couple days ago), except it was all still inside the skin. I finally went back to that image and went to the website to read the story.

This story is kind of a ‘win’ against mainstream medicine, and a win for the anti-surgery people. But yet…. it’s ridiculously horrible at the same time. This guy didn’t want surgery. So he had a hernia for 25 years, and basically, his entire guts spilled into this hernia and he was still alive all that time. (I don’t think mine will do that – I have a suspicion that mine might possibly be femoral.) He went to the doctor and they took this photo of him. He had
constipation for eight days, and that’s why he went to the doctor, but he elected for non-surgical treatments of the constipation. Then ‘he was subsequently lost to follow-up.’

When I say it’s a ‘graphic image,’ I mean it’s an image of a man with a gigantic bag of skin hanging all the way down to his knees, with his guts inside it, still alive.

http://www.nejm.org/doi/full/10.1056/NEJMicm1208699#t=article

Large Right Inguinal Hernia

Horia Parvanescu, M.D.

N Engl J Med 2013; 368:171January 10, 2013DOI: 10.1056/NEJMicm1208699 Share:

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A 67-year-old man presented with a large right inguinal mass that had progressed in size for 25 years. Eighteen years earlier, he had been hospitalized in a general surgery clinic with an inguinal hernia but declined surgical repair because of concern about the
complications associated with the procedure. He returned to the clinic after an 8-day period of constipation. On examination, a hernia, 55 cm in length and 30 cm in width, was noted to reach the level of the knees (Panels A and B). The size of the mass suggested that the patient was at risk for intestinal obstruction, intestinal bleeding, and volvulus. Surgical correction was offered, but because of the risks, including bleeding, intestinal perforation, and failed healing of the abdominal wall, he elected conservative medical management, which included a high-fiber diet and the use of laxatives and enemas. He was subsequently lost to follow-up.

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