Lederhosen Hernia: First Description and Literature Review

Etymologically, hernia means “to protrude or to bud”. Abdominal wall hernias are frequent findings in adult and children imaging. Hernias are described by grading the size of their sacs as well as detailing their coverings and contents. Clinically, hernias are classified based on their reducibility, either by the experienced surgeon or by the patient, into reducible or irreducible. Pathologically, they vary in their potential to be obstructed, inflamed, or strangulated. A crucial part of managing any hernia is to interpret the imaging features in order to classify its type and assess for complications. Ultrasound (US), computed tomography (CT), and magnetic resonance imaging (MRI) are the most recommended imaging modalities. New generations of CT scans play an important role in elective and emergency hernia management. CT scans offer high reliability and sensitivity due to their easy accessibility, fast acquisition speed, higher resolution, and three-dimensional multiplanar reconstruction (3D-MPR). One of the most interesting aspects about hernias is their historically associated nomenclatures commonly published and used in medical education and surgical practice to specifically diagnose different hernia types. Those nomenclature terms (adjective or physician names), rather than anatomical regions, are by far the longest list of nomenclatures known to a single medical condition. Purposefully, the terms are essential for the identification of hernias by remembering and depicting their anecdotes. Similarly, the case presented here, supported by CT still/cine figures, introduces a new subtype of bilateral inguinal hernias where communicating hernial content and location are reminiscent of a “Lederhosen”.