Hernia: sliding hernia: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Hernia: sliding hernia

Sample item

During repair of a long-standing left inguinal hernia in an elderly man, the surgeon finds that part of the posterior wall of the sac is formed by a viscus. Which structure is most likely?

ACaecumBTransverse colonCJejunumDSigmoid colon

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Sigmoid colon

In a sliding hernia a retroperitoneal organ drags its peritoneal covering into the sac, so the organ forms part of the sac wall. On the left it is the sigmoid colon and on the right the caecum. The sac must not be opened carelessly, and the viscus is reduced with its mesentery intact.

Option by option

A. Caecum
The caecum slides on the right side, not the left.
B. Transverse colon
The transverse colon is intraperitoneal and does not slide into an inguinal sac.
C. Jejunum
The jejunum is intraperitoneal with a mesentery and does not form part of a sac wall.
D. Sigmoid colon (correct)
Correct. The sigmoid colon is the usual component on the left.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is D, Sigmoid colon. In a sliding hernia a retroperitoneal organ drags its peritoneal covering into the sac, so the organ forms part of the sac wall.

Why is "Caecum" not the answer?

The caecum slides on the right side, not the left.

Why is "Transverse colon" not the answer?

The transverse colon is intraperitoneal and does not slide into an inguinal sac.

Why is "Jejunum" not the answer?

The jejunum is intraperitoneal with a mesentery and does not form part of a sac wall.

What concept does this question test?

It tests Hernia: sliding hernia in General Surgery. On the left it is the sigmoid colon and on the right the caecum. The sac must not be opened carelessly, and the viscus is reduced with its mesentery intact.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Hernia: sliding hernia?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.