A groin pseudocyst following inguinal hernia repair
Groin hernias are one of the most common general surgery operations performed worldwide. Published in the International Journal of Surgery Case Reports, the authors present an exceedingly unusual complication of a patient who underwent a posterior repair of an inguinal hernia.

A 48-year-old man presented with a chronically enlarging left groin mass for five years following a total extraperitoneal repair of a unilateral inguinal hernia. Two separate aspiration interventions led to rapid re-accumulation of the fluid. Physical exam demonstrated a large inguinoscrotal mass in the left groin.

It was non-tender and there were no overlying skin changes. His testicles were palpable at the bottom of the scrotum. A computed tomography exam demonstrated evidence of a prior left inguinal hernia repair. The left groin/scrotum had a 12 cm fluid collection with incomplete peripheral calcification, consistent with previous history of seroma.

An indirect hernial sac could not be excluded from the diagnosis. During groin exploration an inguinal canal pseudocyst was removed in its entirety without violating the capsule. The patient recovered well; there was no recurrence at a six month follow up.

Review of the literature revealed that only two other cases had been reported, but in contrast to this case, the previous cases had an anterior repair for the index operation and the pseudocysts were open and partly resected.

Highlights
• Groin pseudocyst is a rare complication following inguinal hernia repair. Only two previous cases reported in the literature.

• Pseudocysts can develop following open and laparoscopic mesh repair. Surgery is required for definitive management.

• In this report, the authors discuss a patient who had a groin pseudocyst 5 years after the original operation to repair his hernia.

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