Richter's Hernia in the Laparoscopic Era

Boughey, Judy C.; Nottingham, James; Walls, A.

doi:10.1097/00129689-200302000-00014

Cited by 64 publications

(17 citation statements)

References 7 publications

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“…Richter’s hernia occurs in small hernia rings large enough to entrap the partial circumference of the bowel wall, but small enough to prevent protrusion of a loop of the intestine, with firm margins commonly occuring in the femoral ring (72 %-88 %), followed by inguinal canal (12-24 %) and the abdominal wall incisional hernias (4 %-25 %). Recently several cases have been reported at laparoscopic port insertion sites also [ 3 ]. Unusual occurrences occurs at the insertion site of the drainage tube following open abdominal surgery, as a Spigelian’s hernia, through the sacral foramen [ 1 ].…”

Section: Discussionmentioning

confidence: 99%

A rare case of spontaneous inguinal faecal fistula as a complication of incarcerated Richter’s hernia with brief review of literature

et al. 2015

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BackgroundRichter’s hernia has an early misleading presentation with tendency to strangulation due to common lack of obstructive symptoms which may lead to delay in diagnosis and hence increased mortality. Rarely inguinal Richter’s hernia may present with an uncommon complication of spontaneous fistula. The development of spontaneous faecal fistula secondary to incarcerated inguinal hernias is much rarer among the adult population as compared to the paediatric age group. Most of these fistula have been reported from developing countries like India and Nigeria and is usually the result of poverty, lack of knowledge, neglect, late presentation and lack of proper management.Case presentationA 62 years old male presented with chief complaints of multiple openings with faecal discharge in the right groin for last 20 days with no history of constipation, trauma, and urinary or other abdominal complaints. CT scan revealed a small gut loop communicating with anterior abdominal wall. Exploratory laparotomy revealed a loop of distal ileum adherent to the internal inguinal ring which was retrieved back into the abdominal cavity. There was perforation over the loop. Resection of the segment of ileum involved was done with ileo-ileal hand sewn anastomosis and the internal inguinal ring was closed from inside of the peritoneal cavity. The openings in the skin over the inguinal region were communicated with each other and laid open due to cellulitis of the area involved and pus discharge.ConclusionSpontaneous faecal fistula in inguinal region following rupture of strangulated Richter’s hernia especially in adults is very rare and can occur even in absence of obstructive symptoms. In presentation of any groin swelling, there is need for an early accurate diagnosis followed by prompt treatment. The delay in its diagnosis and management may result in this rare complication of spontaneous faecal fistula. This reflects the state of health care in the developing world and needs to be addressed by the concerned authorities.

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Section: Discussionmentioning

confidence: 99%

A rare case of spontaneous inguinal faecal fistula as a complication of incarcerated Richter’s hernia with brief review of literature

et al. 2015

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“…Importantly, incisional hernias can be associated with significant morbidity in the presence of small-bowel obstruction that, in addition to repair of the hernia, requires bowel resection. 13 Our objectives were to describe the frequency of hernia repairs after RP and estimate the impact of surgical approach on the likelihood of incisional hernia. We hypothesized that there would be a higher risk of incisional hernia repairs associated with MIRP compared to ORP.…”

Section: Introductionmentioning

confidence: 99%

Risk of Incisional Hernia after Minimally Invasive and Open Radical Prostatectomy

et al. 2013

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Purpose The number of radical prostatectomies has increased. Many urologists have shifted from the open surgical approach to minimally invasive techniques. It is not clear whether the risk of post-prostatectomy incisional hernia varies by surgical approach. Materials and Methods In the linked Surveillance, Epidemiology, and End Results (SEER)-Medicare dataset we identified men age 66 and older who had minimally invasive (MIRP) or open radical prostatectomy (ORP) for prostate cancer diagnosed 2003–2007. The main outcome was incisional hernia repair identified in Medicare claims following prostatectomy. We also examined the frequency of umbilical, inguinal and other hernia repairs. Results We identified 3,199 patients who had MIRP and 6,795 who had open radical prostatectomy ORP. The frequency of incisional hernia repair was 5.3% (median follow-up 3.1 years) in the MIRP group and 1.9% (median follow-up 4.4 years) in the ORP group, corresponding to incidence rates of 16.1 and 4.5 per 1000 person-years for MIRP and ORP, respectively. Compared with ORP, MIRP was associated with a more than 3-fold increased risk of incisional hernia repair, controlling for patient and disease characteristics (adjusted hazard ratio 3.39, 95% CI, 2.63–4.38, p <0.0001). MIRP was associated with an attenuated but increased risk of any hernia repair compared with ORP (adjusted hazard ratio 1.48, 95% CI 1.29–1.70, p <0.0001). Conclusions MIRP was associated with a significantly increased risk of incisional hernia compared with ORP. This is a potentially remediable complication of prostate cancer surgery that warrants increased vigilance with respect to surgical technique.

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“…The firm margins commonly occur in the femoral ring (72–88%), followed by inguinal canal (12–24%) and the abdominal wall incisional hernias (4–25%). Several cases have been reported at laparoscopic port insertion sites [5] .…”

Section: Discussionmentioning

confidence: 99%

Spontaneous entero-labial fistula complicating Richters hernia: Report of a case

Elenwo

Igwe

Jamabo

et al. 2016

International Journal of Surgery Case Reports

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Richter's Hernia in the Laparoscopic Era

Cited by 64 publications

References 7 publications

A rare case of spontaneous inguinal faecal fistula as a complication of incarcerated Richter’s hernia with brief review of literature

A rare case of spontaneous inguinal faecal fistula as a complication of incarcerated Richter’s hernia with brief review of literature

Risk of Incisional Hernia after Minimally Invasive and Open Radical Prostatectomy

Spontaneous entero-labial fistula complicating Richters hernia: Report of a case

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