Abstract
Groin hernias are most common hernias in abdominal wall hernias (75%). 95% of groin hernias, are from inguinal canal and remaining area femoral hernias. Two-thirds of the inguinal hernias are indirect and remaining are direct inguinal hernia. An indirect inguinal hernia is the most common, regardless of gender and in men, indirect hernias predominate over direct hernias at a ratio of 2:1. Direct hernias are uncommon. Strangulated external hernia is a relatively common serious surgical emergency. In these approximately 50% of cases involves small bowel obstruction and accounts for most of the deaths from this condition. Presenting a case of 64-year gentleman diagnosed with strangulated right inguinal hernia, managed with urgent surgery and underwent right hemicolectomy with Desarda’s repair in view of gangrenous caecum. This case report underscores the clinical presentation and prompt surgical management of an unusual case of a strangulated right inguinal hernia containing the cecum, entailing both hernia repair and right hemicolectomy. The Desarda’s technique was chosen as the hernia repair method which focuses on autologous tissue repair.
Keywords: Strangulated hernia, Desarda’s repair, right hemicolectomy, ileo-transverse anastomosis, small bowel obstruction.
References
- Mohanty SK, Jena K, Mahapatra T, Dash JR, John A, Meher D. Obstructed direct inguinal hernia: A rare encounter. Int J Case Rep Images 2016;7(9):592–595.
- A McIntosh, A Hutchinson, A Roberts, H Withers, Evidence-based management of groin hernia in primary care—a systematic review, Family Practice, Volume 17, Issue 5, October 2000, Pages 442–447, https://doi.org/10.1093/fampra/17.5.442
- N J Andrews, Presentation and outcome of strangulated external hernia in a district general hospital, British Journal of Surgery, Volume 68, Issue 5, May 1981, Pages 329–332, https://doi.org/10.1002/bjs.1800680513
- Kamat M, Singh N, Nattey K. A rare encounter of obstructed direct inguinal hernia of sliding variety. Int J Surg Case Rep. 2018; 49:209-214. doi: 10.1016/j.ijscr.2018.06.025. Epub 2018 Jun 28. PMID: 30031240; PMCID: PMC6076353.
- Zaki H A, Shaban E E, Zahran A, et al. (December 24, 2021) A Rare Presentation of Small Bowel Obstruction Due to Obstructed Indirect Inguinal Hernia. Cureus 13(12): e20656. doi:10.7759/cureus.20656
- Sudharshan M, Shaikh O, Panneerselvam R, Kumbhar U, Gaur NK. Caecal Volvulus Presenting as the Obstructed Right Inguinal Hernia. Cureus. 2021 Jul 8;13(7):e16264. doi: 10.7759/cureus.16264. PMID: 34373819; PMCID: PMC8346269.
- Park S, Chen MZ. Strangulated inguino-scrotal hernia with caecal perforation. ANZ J Surg. 2022 Oct;92(10):2711-2712. doi: 10.1111/ans.18024. Epub 2022 Sep 10. PMID: 36086885.
- Hernia Surge Group. International guidelines for groin hernia management. Hernia. 2018 Feb;22(1):1-165. doi: 10.1007/s10029-017-1668-x. Epub 2018 Jan 12. PMID: 29330835; PMCID: PMC5809582.
- Ndong A, Tendeng JN, Diallo AC, Diao ML, Diop S, Dia DA, Ma Nyemb PM, Konaté I. Is Desarda technique suitable to emergency inguinal hernia surgery? A systematic review and meta-analysis. Ann Med Surg (Lond). 2020 Dec 2; 60:664-668. doi: 10.1016/j.amsu.2020.11.086. PMID: 33312559; PMCID: PMC7721661.
- Tebala GD, Yee J, Kola-Adejumo A. Laparohernioscopic right colectomy for bowel ischaemia within a strangulated inguinal hernia. Ann R Coll Surg Engl. 2019 May;101(5):e125-e127. doi: 10.1308/rcsann.2019.0043. PMID: 31042432; PMCID: PMC6513374.
Corresponding Author
Sandeep Verma
Senior Resident Department of General Surgery, PGIMS Rohtak