Acute Gastric Rupture in a Giant Inguinoscrotal Hernia

Abstract

Inguinoscrotal gastric herniation is a rare occurrence and generally presents with obstruction when encountered. We present a case of acute spontaneous gastric rupture in a giant inguinoscrotal hernia which was managed surgically in a one-stage procedure with primary gastric and hernia repair. A subtotal colectomy was performed due to risk of volvulus as well as allowing for primary closure of the abdominal wall. This case illustrates the possibilities in terms of hernia size and contents, in addition to the potential complications that may ensue. Moreover, this case illustrates that adherence to the principles of hernia repair can equip the surgeon to deal with rare and unfamiliar presentations.

Bilateral inguinoscrotal hernia with gastric contents and subsequent perforation: Lessons in operative management

“…Many techniques have been used to mitigate this risk which can be seen in Table 1 . These include a one stage complete repair, two stage technique with initial perforation repair and delayed hernia repair, delayed primary closure, pre-operative progressive pneumoperitoneum, abdominal component separation and resection of bowel [ [1] , [2] , [3] , [4] , [5] ]. In this case we opted for a two stage repair, only repairing the immediately offending left hernia and returning to repair the right side at a later date to reduce the risk of abdominal compartment syndrome.…”

“…Gastric perforation has been regularly reported in other cases of inguinoscrotal hernias containing stomach and seems to be a recurrent issue. However, it has been invariably managed with primary repair rather than gastrectomy as in this case [ 4 , 5 , 8 , 9 ].…”

“…One week later the patient underwent relook laparotomy and Bassini repair of the hernia [ 5 ]. Lajevardi et al opted for a one stage approach with primary gastric repair and hernia mesh repair, using midline laparotomy only [ 4 ]. Doggar et al opted for a similar approach to us.…”

Surgical treatment strategies for giant inguinoscrotal hernia – a case report with review of the literature

“…It is necessary to treat inguinoscrotal hernias, since organ perforation can occur, potentially causing peritonitis and sepsis [ 9 , 10 ]. It is proved that early elective operations are associated with less fatal complications than emergency interventions [ 11 ].…”

A case report of a gastric perforation in a giant inguinoscrotal hernia: A two-step approach

“…It is an uncommon condition and rarely encountered in clinical practice. Severe complications such as duodenal [[2], [3], [4], [5]] and gastric [[6], [7], [8]] perforation have been reported with high morbidity and mortality rate. In line with the SCARE criteria [9], we are presenting a case report of a gastric perforation in a giant inguinoscrotal hernia which was managed surgically in a two-step approach.…”