Maydl's hernia: report of a series of seven cases and review of the literature.

Seven cases of Maydl's herniae with two patients needing resection of bowel are presented. This condition is rare and may be lethal if unrecognized. The hernial sac contains two loops of bowel with another loop of bowel being intra-abdominal. The intra-abdominal loop of bowel may become strangulated, either alone or in combination with bowel in the hernial sac. It is more often seen in men, and predominantly on the right side. Maydl's hernia should be suspected in patients with large incarcerated herniae and in patients with evidence of intra-abdominal strangulation or peritonitis. Postural or manual reduction of the hernia is contra-indicated as it may result in non-viable bowel being missed.