Introduction: Richter's hernia is an abdominal hernia in which part of the circumference of the intestine is incarcerated in the hernia sac. Case report: We report a case of Richter's hernia incarcerated through an indirect inguinal hernia. The patient presented with an occlusive syndrome with an imaging appearance of a right inguinal hernial strangulation bowel obstruction. Surgical exploration revealed the presence of an indirect inguinal Richter's hernia with a viable bowel. Discussion: Richter's hernia is a rare hernia of the abdominal wall, it is known by the unusual clinical presentation and the often erroneous late diagnosis that leads to high morbidity and mortality rates. Therefore, with high clinical suspicion, an abdominal CT scan is recommended to establish a prompt diagnosis, as timely surgical intervention is important to reduce mortality. Conclusion: Surgery is the basis of its treatment, but prompt surgical intervention remains. Assessment of bowel viability is an essential part of the repair.
Introduction: Adenosquamous Carcinoma (ASC) of the anus presenting both glandular and squamous histopathologic features is a rare colorectal neoplasm. Case presentation: A 63-year-old man presented with a one-year history of intermittent rectal pain and bleeding on a perineal fistula. Pathological analysis of the surgical specimen revealed adenosquamous carcinoma of the anus, The patient received neoadjuvant treatment with chemotherapy and radiotherapy over a period of five weeks. then he underwent abdominoperineal resection and a permanent colostomy. Histology revealed invasive adenosquamous carcinoma on the resection specimen and the patient was started on adjuvant therapy with FOLFIRINOX. Discussion: Primary ASC of the colon and rectum are extremely rare clinical entities with poor prognosis. Most of the data come from individual case reports and a few small series, making it a challenge to understand the histogenesis of the disease. And the treatment modalities are not yet well codified, which has an impact on overall survival. Conclusion: Early diagnosis and radical surgery with other available therapeutic modalities can improve clinical outcomes.
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