A STRANGULATED LEFT INGUINAL HERNIA CONTAINING THE SPLENIC FLEXURE OF TRANSVERSE COLON: AN UNUSUAL CASE REPORT sejalgrover98@gmail.com

PE031

A STRANGULATED LEFT INGUINAL HERNIA CONTAINING THE SPLENIC FLEXURE OF TRANSVERSE COLON: AN UNUSUAL CASE REPORT

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India

Oral or Poster

Obstruction and strangulation are the most serious complications of inguinal hernia. The sac of an inguinal hernia most frequently contains omentum, small intestine and uncommonly appendix, Meckel's diverticulum, ovary, or urinary bladder. The transverse colon is not a common hernia content in an inguinal hernia. A rare case of strangulated left inguinal hernia containing the splenic flexure of transverse colon is described here.

A 27 year old male presented to the ED with irreducible left groin swelling since 3 days, associated with intractable pain and non- bilious vomiting. He had a past history of one similar episode of left inguinal swelling 6 months back. Patient is a chronic drug abuser. On examination, the abdomen was mildly distended, bowel sounds were sluggish and there was a mild diffuse tenderness without peritoneal signs. In the left inguinal region, there was a large, tender, irreducible hernia with absent bowel sounds in the hernial sac. On per-rectal examination, rectal cavity was collapsed with absence of stool staining.

At surgery, the hernia was approached through an left inguinal incision. Sac contained the ischemic colon and omentum. The infarcted bowel was resected and anastomosis of the transverse and descending colon was done with a diversion ileostoma (due to emergency surgery). Only primary closure done, no mesh was placed at the hernia defect.

It is better to evaluate the patient with radiological methods even in complicated cases to confirm the hernial content