An unusual case of a strangulated right inguinal hernia containing the sigmoid colon

Bali, Christina; Tsironis, Apostolos; Zikos, Nicolaos; Mouselimi, Mairi

doi:10.1016/j.ijscr.2011.01.005

Cited by 19 publications

(29 citation statements)

References 15 publications

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“…The classical finding is epiploic appendagitis (typically due to torsion of the appendage), which can mimic acute appendicitis in that anatomical situation [4, 11, 12]. During the last decade, certain unique versions of complicated RIH have been published: the strangulation and necrosis of the dolichosigmoid [13]; the combination of a dolichosigmoid volvulus with its strangulation in a RIH [14]; and sigmoid colon cancer, complicated by an obstruction and/or paracolic abscess, with the tumor located in the hernia sac of a RIH [15, 16]. These research studies cannot be considered to be “purely” casuistic, even though the studies are very interesting and significant in this aspect; particularly rare cases, excellent illustrations, and optimal surgical tactics also make these publications very valuable.…”

Section: Discussionmentioning

confidence: 99%

Strangulation and Necrosis of an Epiploic Appendage of the Sigmoid Colon in a Right Inguinal Hernia

Shiryajev

Glebova

Chalenko

2013

Case Reports in Surgery

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An epiploic appendage of the sigmoid colon is considered to be an unusual type of inguinal hernia content. The strangulation of a sigmoid colon appendage into a right inguinal hernia is exclusively rare. We present a case of an 81-year-old female patient with severe cardiovascular comorbidities who was urgently admitted after an episode of strangulation and subsequent spontaneous reduction of a right inguinal hernia. The condition of the patient was stable, and an urgent operation was not indicated for three days after admission. However, we had to operate because the hernia strangulation recurred. In the hernia sac, a free fatty body (a separated and saponified epiploic appendage of the colon) and a strangulated epiploic appendage of dolichosigmoid, with signs of necrosis, were found. Removal of the free fatty body and necrotic epiploic appendage and subsequent anterior-wall inguinal hernioplasty were successfully performed. In the world literature, this case may be the first report of a sigmoid epiploic appendage strangulation in a right inguinal hernia that is well documented by photography.

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Section: Discussionmentioning

confidence: 99%

Strangulation and Necrosis of an Epiploic Appendage of the Sigmoid Colon in a Right Inguinal Hernia

Shiryajev

Glebova

Chalenko

2013

Case Reports in Surgery

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“…The choice of technique depends on several factors, including the type of hernia, anaesthetic considerations, cost, period of postoperative disability and the surgeon's expertise. [16][17][18][19] In the primary management of all complicated hernias from surgical reduction and repair accompanied by aggressive pre and postoperative care is suggested. Elective repair should be deferred in case of advancing age and in case in which groin hernia may be difficult to diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Clinical study on complicated presentations of groin hernias

Teerthanath

2017

Int J Res Med Sci

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Background: Groin hernia is a very common type abdominal wall hernia encountered in surgical practice. Irreducibility, obstruction and strangulation are its commonest complications which usually presents as acute emergencies. Emergency repair of complicated hernias is associated with poor prognosis and a high rate of postoperative complications even with better care, improved anaesthetic management and advanced surgical techniques. The aim of this study was to determine the various modes of presentation, clinical finding, diagnostic and therapeutic strategies and to evaluate the postoperative outcome in complicated groin hernia surgeries in our set up. Methods: The study was carried out among 40 patients of groin hernia, who had complicated clinical presentation like irreducibility, strangulation and obstruction in the department of general surgery, during the period from March 2012 to June 2014. Patients were enrolled into the study after proper consent for detailed clinical examination, investigation and subsequent treatment. The Data obtained included demographic characteristics, presentation, operative findings and outcome. The patients were followed up for immediate and late complications for once a week for 1 months, once every month for the next 6 months. After data collection, analysis was done with help of by SPSS software version 21. Results: A total of 40 groin hernia patients with complicated presentation were evaluated during the study period. Among these cases 38 cases had inguinal hernias and two cases had femoral hernia. Majority of the patients were in 5th and 6th decade. Complicated presentation of groin hernia was commonly seen in males (95%) than in females (5%) with male to female ratio of 19:1. Inguinal hernia complications were seen predominantly in males and femoral hernia complications in females. Right sided hernias were more common. Incarceration was the commonest complication seen in 70% of case followed by strangulation (30%). Incarceration was high (17.5%) in the age group of 64-73 years and 44 -53 years. Strangulation was high in the age group of 54-63 years. The duration of hernia varied for 1-2 years in 42.5% of cases and 3-6 years in 27.5% of cases. Majority of the patients (30%) presented with localized groin pain, vomiting, constipation and abdominal distension. All patients presented with swelling in the inguinoscrotal region, which was tender, and there was no impulse on coughing and 35% of patients had cardiorespiratory illness. Majority of the cases (34 numbers) were operated as emergency procedure. Viable bowel was seen in 77.5% of cases. Bowel resection and end-to-end anastomosis was done in all cases of non-viable bowel and orchidectomy in atrophied and gangrenous testis. The commonest postoperative complication encountered in the study was wound infection (22.5%) and scrotal seroma (17.50%). There was no evidence of recurrence in any of the operated cases. Conclusions: Complicated presentations of groin hernias like, incarceration and strangulation are seen in ...

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“…5,6 Even in the urgency of a strangulated hernia, a thorough preoperative evaluation utilizing imaging methods accordingly is required in order to make the right diagnosis and to exclude concomitant intra-abdominal pathology. 2 But Volvulus proximal to actual strangulated hernia apparently offers no sure means of diagnosis other than routineabdominal exploration-a procedure which is manifestly not to be recommended. 3 …”

Section: Discussionmentioning

confidence: 99%

“…1 The strangulated inguinal hernia on the other hand is one of the most common emergencies in surgery, which occurs in approximately 1-3% of groin hernias.The sac of an inguinal hernia most frequently contains the intestine and the omentum and uncommonly the appendix, the Meckel diverticulum, the ovary or the urinary bladder. 2 A coincidence of both is a rare entity with very few cases reported in literature. Volvulus may produce in a hernia signs and symptoms which accurately simulate hernial strangulation; or it may be associated with actual strangulated hernia.…”

Section: Introductionmentioning

confidence: 99%

Intestinal gangrene due to small bowel volvulus masquerading as strangulated inguinal hernia – A diagnostic dilemma.

Janhavi¹,

Prathiba²,

Kumar³

et al. 2013

Int J of Biomed & Adv Res

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An unusual case of a strangulated right inguinal hernia containing the sigmoid colon

Cited by 19 publications

References 15 publications

Strangulation and Necrosis of an Epiploic Appendage of the Sigmoid Colon in a Right Inguinal Hernia

Strangulation and Necrosis of an Epiploic Appendage of the Sigmoid Colon in a Right Inguinal Hernia

Clinical study on complicated presentations of groin hernias

Intestinal gangrene due to small bowel volvulus masquerading as strangulated inguinal hernia – A diagnostic dilemma.

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