Presentation
Left groin swelling. Absolute constipation. Abdominal distension.
Patient Data
Age: 75 years
Gender: Male
From the case:
Large bowel obstruction caused by left inguinal hernia
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Large left inguinoscrotal hernia containing part of the sigmoid colon with tight compression at the hernia neck, causing proximal large and small bowel obstruction due to incompetent ileocecal valve. There is also a small volume of free fluid in the hernia sac and the abdominal cavity. No perforation.
Case Discussion
The segment of large bowel in the hernia sac is effectively a short but closed loop. Incompetence of the ileocecal valve allows free reflux of gas into the small bowel, leading to additional small bowel obstruction. At surgery, the hernia sac was reduced and the hernia closed and no bowel needed to be resected.
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