A rare content in inguinal hernial sac, masquerading as scrotal tumour.

Some of the commonly performed operations can become difficult due to unusual findings which are seen during surgery. One such sort of operation is hernia repair. Decision making during such situations could be challenging, even for experienced surgeons. We are reporting here a rare case of a terminal ileal intussusception in inguinal hernial sac, which presented as a scrotal tumour. A 45-year-old man presented with an uncomplicated left inguinoscrotal swelling of 4 years duration. He had a large non-transilluminant hydrocoele (20x 10cm) with a partially reducible inguinal hernia, with another scrotal mass mimicking a scrotal tumour. Sonographic evaluation showed a complex scrotal mass with bowel loops in the sac. On surgical exploration, a terminal ileal intussusception mass was noted in the sac, which required ileocaecal resection by laparotomy. This case report is an unusual presentation of a common disease. Surgeons should be aware of these unusual contents in hernial sac, for better decision making and management during hernia operations.