Abscess in the inguinal hernial sac after peritonitis surgery: A case report

Ikeda, Satoshi; Takeda, Haruka; Yoshimitsu, Masanori; Hinoi, Takao; Yoshida, Makoto; Sumitani, Daisuke; Takakura, Yuji; Kawaguchi, Yasuo; Shimomura, Manabu; Tokunaga, Masahito; Kawahori, Katsufumi; Ohdan, Hideki; Okajima, Masazumi

doi:10.3748/wjg.15.1007

Cited by 8 publications

(2 citation statements)

References 10 publications

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“…After the initial reports of inguinal hernia sac abscesses following management of peritonitis by Cronin been reported. Other cases of hernia sac abscesses have been related to appendicitis, especially in the setting of Amyand or De Gargenot hernias [3][4][5][6][7], diverticular abscesses [8][9][10], Littre hernia [11], cancer [12], other colonic pathology [13], and even colorectal surgery [14]. Also, in an earlier era, several reports described cases in which a hernia sac abscess was identified before a diagnosis of generalized peritonitis was made [15][16][17][18], but this phenomenon may have been a result of the limitations of the diagnostic imaging modalities that were available at the time, and is not expected to persist in the modern era in which CT imaging enables surgeons to diagnose specific causes of peritonitis promptly.…”

Section: Discussionmentioning

confidence: 99%

Inguinal Sac Abscess Masquerading as a Strangulated Inguinal Hernia after Antrectomy and Proximal Duodenectomy for Perforated Peptic Duodenal Ulcer

LiMichael

SarkarBedabrata

Kofi

et al. 2017

Surgical Infections Case Reports

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Background: Patients who undergo surgery for a perforated duodenal ulcer are at risk of developing an intraabdominal abscess. Even in this setting, the possibility of developing an inguinal hernia sac abscess is rare. Case Presentation: We report the case of a 66-year-old male who underwent an antrectomy and proximal duodenectomy, truncal vagotomy, Billroth II gastrojejunostomy, and a Witzel tube jejunostomy for a recurrent perforated duodenal ulcer. Seven days after this operation, he developed symptoms concerning for a strangulated left inguinal hernia. At operation, a hernia sac abscess of Candida glabrata was identified and excision of the hernia sac and McVay herniorrhaphy were performed. Conclusion: An inguinal sac abscess may develop in patients who have undergone surgery for perforated peptic ulcers and can masquerade as a strangulated inguinal hernia. In the post-operative period, it should be considered in patients who develop an acute onset of groin pain. Definitive management should include excision of the sac and herniorrhaphy without a mesh prosthesis to limit the risk of a chronic wound infection.

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Section: Discussionmentioning

confidence: 99%

Inguinal Sac Abscess Masquerading as a Strangulated Inguinal Hernia after Antrectomy and Proximal Duodenectomy for Perforated Peptic Duodenal Ulcer

LiMichael

SarkarBedabrata

Kofi

et al. 2017

Surgical Infections Case Reports

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“…Understanding the etiology of the inguinal abscess is helpful in guiding definitive treatment and the prescription of empiric antibiotics. Inguinal abscesses resulting from extrapelvic pyomyositis usually appear as well-defined cavities, while those resulting from intrapelvic infection may be complicated by underlying bowel disease, infective spondylodiskitis, or urinary tract infection [9-20]. Empiric antibiotics and surgical planning should be guided by the pathophysiology of the disease.…”

Section: Introductionmentioning

confidence: 99%

The role of cross sectional imaging in the management of acute pyogenic inguinal abscess - extrapelvic versus intrapelvic origin

et al. 2013

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BackgroundAbscesses involving the inguinal region as manifestations of complex soft-tissue infections are rare, and the infectious route is usually unclear. The purpose of this study was to ascertain the importance of imaging study and whether the clinical presentations differ between the extrapelvic and intrapelvic origin.MethodsPatients who presented with inguinal abscess between January 2003 and December 2010 were evaluated retrospectively. All patients received broad-spectrum antibiotic therapy and debridement. Imaging studies, including computed tomography or magnetic resonance imaging, were performed in all patients to elucidate the origin and extent of infectious disease, and the results were reviewed. Clinical data, laboratory examination findings, and culture results were analyzed.ResultsTwenty-eight patients were enrolled in the study: 13 patients whose infections were of extrapelvic origin (Group 1) and 15 patients of intrapelvic origin (Group 2). Imaging studies yielded information that helped guiding the treatment. Gram-positive coccus infection was more frequent in Group 1 (p < 0.001), while mixed pathogen and anaerobic bacterial infection were more frequent in Group 2 (p = 0.002 and p = 0.006, respectively). Group 2 had a higher incidence of history of malignancy and chronic renal failure (p = 0.044 and p = 0.038, respectively).ConclusionsComputed tomography and magnetic resonance imaging are helpful in diagnosing cases of inguinal abscess and determining the extent of infection. In patients presenting with acute pyogenic inguinal abscess, a higher prevalence of chronic renal failure and history of malignancy were found in those with an intrapelvic, as compared with an extrapelvic, origin of infection.

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Acute Pyogenic Inguinal Abscess from Complex Soft-Tissue Infection or Intra-Abdominal Pathology

Hsu

Lai

Peng

et al. 2014

Surgical Infections

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Abscess in the inguinal hernial sac after peritonitis surgery: A case report

Cited by 8 publications

References 10 publications

Inguinal Sac Abscess Masquerading as a Strangulated Inguinal Hernia after Antrectomy and Proximal Duodenectomy for Perforated Peptic Duodenal Ulcer

Inguinal Sac Abscess Masquerading as a Strangulated Inguinal Hernia after Antrectomy and Proximal Duodenectomy for Perforated Peptic Duodenal Ulcer

The role of cross sectional imaging in the management of acute pyogenic inguinal abscess - extrapelvic versus intrapelvic origin

Acute Pyogenic Inguinal Abscess from Complex Soft-Tissue Infection or Intra-Abdominal Pathology

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