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Background - Sciatic hernias are considered
the rarest pelvic floor hernias, with a
very limited number of published reports
worldwide. Case report - We report a 43
year old female who presented with a
slow growing swelling in the left gluteal
region. Examination revealed a soft,
partly reducible, swelling with expansile
impule on coughing. At laparotomy the
cyst was found to be arising between the
two layers of the broad ligament and
passing through the greater sciatic foramen.
The content of the cyst was dark
brown fluid. The cyst was excised and a
prolene mesh plug was placed in the defect.
Histopathology of the cyst showed a
simple serous cyst. Conclusions - Sciatic
hernia is unusual, and can present with
diagnostic and treatment dilemmas. The
hernia may present with obscure pelvic
pain, intestinal obstruction, lifethreatening
gluteal sepsis, or as an asymptomatic,
reducible mass that distorts
the gluteal fold. Small sciatic hernia can
remain hidden behind
the gluteus maximus muscle. The diagnosis
requires imaging studies in such cases.
Treatment of sciatic hernia is always surgical
and requires prosthetic reinforcement
for the best result.

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