Irreducible inguinal hernia with intrasaccular perforated sigmoid malignancy

Abstract

Irreducible inguinal hernias are commonly encountered in an emergency setting. The content is usually small bowel or omentum and diagnosis is made by physical examination. We present a case of an irreducible inguinal hernia, which on opening of the sac revealed a perforated sigmoid colonic growth as the content.

Necrotizing abdominal process masquerading as a ruptured strangulated inguinal hernia

“…This case was complicated by the initial presumptive diagnosis of a perforated, strangulated inguinal hernia containing small bowel on a background of known bilateral inguinal hernias derived from the clinical and radiological findings evolving into a situation of dual pathology. Up to 0.5% of all inguinal hernias are due to malignancy with direct involvement of the malignant segment of bowel within the hernial sac . No literature to date has reported a case of sigmoid cancer fistulating into adjacent mesentry and omentum, with a pyogenic reaction tracking down omentum through an inguinal hernia and subsequently into and through the hernial sac, leading to necrotizing infection of the inguinal region.…”

“…Up to 0.5% of all inguinal hernias are due to malignancy with direct involvement of the malignant segment of bowel within the hernial sac. [1][2][3] No literature to date has reported a case of sigmoid cancer fistulating into adjacent mesentry and omentum, with a pyogenic reaction tracking down omentum through an inguinal hernia and subsequently into and through the hernial sac, leading to necrotizing infection of the inguinal region. This is made more unusual due to S. anginosus being commonly found in the oral cavity and is a commensal.…”