. Surgery, its principles and practice . Fig. 32.—Rare Type of Undescended Testis withHernial Sac Extending to Bottom of Arrested at External Ring. PLATE. Strangulated Properitoneal and Omental Hernia with Bilocular Sac. INGUINAL HERNIA. 63 the delay in advising operationwhich is usually observed in thesecases. Properitoneal hernia is oftenmistaken for reduction en masse,and it is almost certain that manycases reported under this headinghave been, in reality, examples ofproperitoneal hernia. Properitonealfemoral hernia is exceedingly rare,Breiter having been able to collectonly
. Surgery, its principles and practice . Fig. 32.—Rare Type of Undescended Testis withHernial Sac Extending to Bottom of Arrested at External Ring. PLATE. Strangulated Properitoneal and Omental Hernia with Bilocular Sac. INGUINAL HERNIA. 63 the delay in advising operationwhich is usually observed in thesecases. Properitoneal hernia is oftenmistaken for reduction en masse,and it is almost certain that manycases reported under this headinghave been, in reality, examples ofproperitoneal hernia. Properitonealfemoral hernia is exceedingly rare,Breiter having been able to collectonly nine cases: four left, threeright, two doubtful. Diagnosis.—The diagnosis ofproperitoneal hernia has seldombeen made before operation. Givena small inguinal hernia, associatedwith undescended testis, and in ad-dition a tumor in the iliac fossa,one should suspect the existence ofa properitoneal hernia. Treatment.—All cases of bilocu-lar hernia, even if the diagnosis ismerely suspected, should be treatedby operation. Interstitial Hernia.—Here theouter sac may l^e really secondary.
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