An Incarcerated Colon Inguinal Hernia That Perforated into the Scrotum and Exhibited an Air-Fluid Level

Abstract

There are few reports of a transverse colon inguinal hernia; furthermore, an inguinal hernia perforating the scrotum is rare. Here we report the case of a 79-year-old man who died after developing an incarcerated colon inguinal hernia that perforated the scrotum and exhibited an air-fluid level. The patient was referred to our hospital in November 2011 with a complaint of inability to move. Physical examination revealed an abnormally enlarged left scrotum and cold extremities. He reported a history of gastric cancer that was surgically treated more than 30 years ago. His white blood cell count and C-reactive protein level were elevated. Abdominal and inguinal computed tomography revealed that his transverse colon was incarcerated in the left inguinal canal. Free air and air-fluid level were observed around the transverse colon, suggestive of a perforation. The patient and his family refused any surgical intervention; therefore, he was treated with sultamicillin tosilate hydrate and cefotiam hydrochloride. However, he succumbed to panperitonitis 19 days after admission. The findings from this case indicate that the transverse colon can perforate into an inguinal hernia sac.

Laparoscopic surgery without peritoneal space contamination in perforated acute abscedated diverticulitis of incarcerated inguinoscrotal hernia

“…Combination of inguinoscrotal hernia and diverticulitis is a rare couple [1][2][3]. In acute scrotum, patient presents acute pain in scrotal bag or its content and could be followed by infl ammation, blush, oedema and size increase [3,4]. Cause of acute abdomen in this patient was a perforated diverticula with a previous inguinoscrotal hernia.…”

“…PubMed's review (Table 1) of similar cases showed rarity of this clinical presentation, laparoscopic Hartmann's intervention is the most common [1][2][3][4][5][6][7][8][9].…”

Pneumohernios due to perforated cecum in left Amyand's hernia

“…Although free air in hernia sac has been reported in some case reports,[ 6 ] a specific term has never been used for this so we propose usage of the term “pneumohernios” (Gk., pneumon - lung, air; Gk., hernios - split, rupture) for clinical, radiological, or per-operatively demonstrable free air in any hernial sac as was evident in our case.…”

Perforated adenocarcinoma of the colon within a scrotal hernia imaged by CT: case report and literature review

“…A recent review found less than 40 reported cases, and establish that complications is often seen in these cases, such as perforation or incarceration [5]. Only a few cases of colon cancer and inguinoscrotal hernias have been reported in the literature [5], [6], [7], [8], [9], [10], [11], [12], [13], [14].…”