Unusual clinical presentation of a preperitoneal hernia following endoscopic totally extraperitoneal inguinoscrotal hernia repair

Breach of the peritoneal cavity during totally extraperitoneal (TEP) inguinal hernioplasty is not an uncommon event. If left unclosed, it can potentially lead to bowel obstruction. Primary repair of such a defect can therefore be very beneficial to the patient, however it doesn't necessarily prevent it. I present the case of an incomplete small bowel obstruction following elective TEP repair of an inguinoscrotal hernia with primary closure of the divided hernia sac. The lesson learned from this patient is to remain suspicious of any unusual (even mild) post-operative abdominal symptom that could be the first sign of an early complication, especially when the initial repair was presumably satisfactory.