Carcinoma of the sigmoid presenting as a right inguinal hernia

Abstract

We present the case of a 44-year-old man who presented with nausea, vomiting and acute pain in the right groin. On physical examination an irreducible mass was palpated in the right inguinal region. Ultrasound suggested an inguinal hernia sac with bowel contents. Subsequent right inguinal exploration revealed only unspecified necrotizing tissue, but no hernia sac or bowel contents were identified. Two days later laparotomy was required since the inguinal wound produced faecal discharge. The sigmoid appeared to be necrotic and perforated, and was subsequently resected. Histology revealed a perforated adenocarcinoma without lymph node involvement. Incarcerated inguinal hernias containing an adenocarcinoma of the colon are rare, but should be considered in patients presenting with an irreducible palpable mass in the inguinal region. Moreover, a carcinoma of the sigmoid may invade the right inguinal region. An intestinal perforation to skin-level in this population is even rarer and is associated with high morbidity and mortality rates.

Synchronous colonic carcinomas presenting as an inguinoscrotal hernial mass: a case report

“…The previously reported cases were mainly of sigmoid tumours [5] and to our best knowledge, this is the first reported case of a primary tumour of the transverse colon presenting in an inguinal hernia, in addition to a synchronous tumour at the ascending colon. Intraoperatively, the colonic attachments at the splenic flexure were intact.…”

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

“…[14][15][16] In two of them the clinical presentation was related to complicated sigmoid pathology, volvulus and carcinoma respectively. 14,16 In the third case a strangulated hernia was misdiagnosed in a patient suffered from a fecal peritonitis due to perforated sigmoid cancer. 15 In most cases the clinical examination is sufficient to diagnose a complicated inguinal hernia.…”

“…[6][7][8][9][10][11] Inguinal hernia sacs in 0.5% of cases contain malignancies, either of saccular origin or generating from the herniated organ, usually sigmoid, cecum and other parts of colon. [12][13][14] In our case the content of hernia sac was the strangulated loop of an otherwise normal sigmoid colon. Due to anatomical considerations the sigmoid colon is commonly found to herniate through abdominal defects at the left inguinal region, especially as a sliding hernia.…”

Preoperative sonography of nonreducible inguinal masses in girls

“…Boormans et al 5 reported a patient who presented with nausea, vomiting, and acute abdominal pain. Sonographic evaluation suggested an inguinal hernial sac with bowel contents; however, subsequent right inguinal exploration revealed only unspecified necrotizing tissue, the histologic examination of which revealed a perforated adenocarcinoma.…”