Richter's Hernia or Partial Enterocele

Zoras

et al. 2006

The American Surgeon

Richter hernia (partial enterocele) is the protrusion and/or strangulation of only part of the circumference of the intestine's antimesenteric border through a rigid small defect of the abdominal wall. The first case was reported in 1606 by Fabricius Hildanus. The first definition of partial enterocele was given by August Gottlieb Richter in 1785. Sir Frederick Treves discriminated it from Littre hernia (hernia of the Meckel diverticulum). More often these hernias are diagnosed in the sixth and seventh decades of life. They comprise 10 per cent of strangulated hernias. Their common sites are the femoral ring, inguinal ring, and at incisional trauma. The most-often entrapped part of the bowel is the distal ileum, but any part of the intestinal tube may be incarcerated. These hernias progress more rapidly to gangrene than other strangulated hernias, and obstruction is less frequent. The gold standard technique for repair is the preperitoneal approach, followed by laparotomy and resection if perforation is suspected.

Section: Incidencesupporting

confidence: 60%

Richter Hernia: Surgical Anatomy and Technique of Repair

Zoras

et al. 2006

The American Surgeon

“…August Richter, a surgeon in Gottingen, reviewed a series of partial enterocoeles [ 17851 and "established the individuality of the lesion" which now bears his name (Treves, 1887). T h e most common sites for a Richter hernia are the femoral ring (71%), the deep inguinal ring (23%), and ventral or umbilical hernias (6%) (combined series ofTreves, 1887; Frankau, 1931;Gillespie et al, 1956).…”

Section: Discussionmentioning

confidence: 98%

Case report and review of literature: Richter hernia in an anterior sacral foramen

et al. 1991

An external hernia is an abnormal protrusion of intraabdominal tissue or the whole or part of a viscus through an opening or fascial defect in the abdominal wall (Deveney, 1985); where a portion of the bowel circumference protrudes into the hernial sac it is termed a Richter hernia. Most commonly, the antimesenteric border of the distal ileum protrudes into the femoral or inguinal rings (Frankau, 1931), presenting as intestinal obstruction (50%), perforation (35%), or perforation leading to an intestinal cutaneous fistula (15%) (Gillespie et al., 1956). One case has been reported of a Richter hernia in an anterior sacral foramen (Botsford, 1977). This is the second such report but, after perforation, the route taken by the intestinal contents through the gluteal region, resulting in cellulitis of the anterolateral aspect of the right thigh, is unique.

International Journal of Surgery Case Reports

“…Femoral hernias also pass through the tight femoral canal and are more likely to strangulate [15] . Occasionally, only part of the bowel circumference will be involved leading to incarceration/strangulation without obstruction (Richter’s hernia) [16] . Partial involvement of the bowel wall and over a small segment can be more easily reduced and less likely to require resection, allowing for the development of a delayed ischemic stricture.…”

Section: Discussionmentioning

confidence: 99%

Intestinal stenosis of Garré: A rare cause of small bowel obstruction in the virgin abdomen

Ismael

Ragoza

Cox

2016

HighlightsReports of strictures following strangulated hernia repair are few, presented in different languages, and the data is frequently incomplete. We present a case report and a comprehensive literature review over the last century.Intestinal stenosis of Garré was more frequently reported to follow inguinal hernia repair than femoral hernia repair (57.1% vs. 42.9%).Most males developed a delayed stricture following an inguinal hernia repair (93.3%). 84.6% of females, on the other hand, developed intestinal stenosis following repair of a femoral hernia87.5% of strictures developed on the right side. The terminal ileum is the narrowest part of the small bowel and is the segment where a stricture would result in the biggest impact.The timing of development of a bowel obstruction is very variable and ranges from 5 days to 22 years. 22 patients (68.8%), however, presented with an obstruction within 5 months of hernia repair.