Strangulated Inguinal Hernia Caused by Obstructive Sigmoid Colon Carcinoma: A Case Report

Abstract

Abstract

Background:
Inguinal hernias are common in the general population and typically contain omentum or small bowel. However, there have also been reports of unusual contents within the hernia sac. We present a rare case of a strangulated left inguinal hernia containing an obstructing sigmoid colon carcinoma.

Case Presentation:
A 69-year-old male presented with a several-day history of abdominal pain, distension, vomiting, and bilateral groin swelling. Physical examination revealed a tense abdomen and bilateral inguinal hernias, with the left side being non-reducible. An abdominal CT scan demonstrated herniation of the sigmoid colon into the left inguinal canal, marked colonic dilatation, and air-fluid levels. Emergency surgery was performed through a right inguinal incision, revealing a strangulated segment of the sigmoid colon with a completely obstructing intraluminal mass. To ensure oncologic adequacy, a laparotomy and Hartmann’s procedure were carried out. Due to contamination, the posterior wall of the inguinal canal was repaired without the use of mesh. The patient was discharged on postoperative day 7.

Conclusion:
Surgeons should consider the possibility of underlying colorectal malignancy when operating on inguinal hernias, particularly in cases of incarceration, and should ensure appropriate oncologic resection and lymphadenectomy when indicated.