Case Report: Fournier\'s gangrene complicating ruptured Richter\'s inguinal hernia

Onakpoya, Uvie Ufuoma; Lawal, O O; Onovo, O D; Oribabor, Felix O

doi:10.4314/wajm.v26i4.28334

Cited by 6 publications

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“…About 8 cases of scrotal faecal fistula have been reported in literature as a complication of inguinal hernia in paediatrics age group [ 6 , 8 , 11 – 17 ] and 8 cases of scrotal fistula as complication of inguinal hernia in adults [ 7 , 10 , 18 – 24 ] have been reported in literature. Onakpoya et al [ 25 ] from Nigeria reported the case of a neglected Richter’s inguinal hernia presenting with perforation and Fournier’s gangrene. Three cases of spontaneous perforation of Richter’s inguinal hernia with Fournier’s gangrene were reported by Guzzo et al [ 26 ] in 2007 from the United States of America.…”

Section: Discussionmentioning

confidence: 99%

A rare case of spontaneous inguinal faecal fistula as a complication of incarcerated Richter’s hernia with brief review of literature

et al. 2015

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BackgroundRichter’s hernia has an early misleading presentation with tendency to strangulation due to common lack of obstructive symptoms which may lead to delay in diagnosis and hence increased mortality. Rarely inguinal Richter’s hernia may present with an uncommon complication of spontaneous fistula. The development of spontaneous faecal fistula secondary to incarcerated inguinal hernias is much rarer among the adult population as compared to the paediatric age group. Most of these fistula have been reported from developing countries like India and Nigeria and is usually the result of poverty, lack of knowledge, neglect, late presentation and lack of proper management.Case presentationA 62 years old male presented with chief complaints of multiple openings with faecal discharge in the right groin for last 20 days with no history of constipation, trauma, and urinary or other abdominal complaints. CT scan revealed a small gut loop communicating with anterior abdominal wall. Exploratory laparotomy revealed a loop of distal ileum adherent to the internal inguinal ring which was retrieved back into the abdominal cavity. There was perforation over the loop. Resection of the segment of ileum involved was done with ileo-ileal hand sewn anastomosis and the internal inguinal ring was closed from inside of the peritoneal cavity. The openings in the skin over the inguinal region were communicated with each other and laid open due to cellulitis of the area involved and pus discharge.ConclusionSpontaneous faecal fistula in inguinal region following rupture of strangulated Richter’s hernia especially in adults is very rare and can occur even in absence of obstructive symptoms. In presentation of any groin swelling, there is need for an early accurate diagnosis followed by prompt treatment. The delay in its diagnosis and management may result in this rare complication of spontaneous faecal fistula. This reflects the state of health care in the developing world and needs to be addressed by the concerned authorities.

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Section: Discussionmentioning

confidence: 99%

A rare case of spontaneous inguinal faecal fistula as a complication of incarcerated Richter’s hernia with brief review of literature

et al. 2015

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“…Although spontaneous enterolabial fistula in a strangulated Richter's hernia is uncommon, our index case presented with a fistula. From the literature review, some researchers, Onakpoya et al [11] and Guzzo et al [12] reported perforation with formation of Fournier's gangrene in neglected Richter's inguinal hernia.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous entero-labial fistula complicating Richters hernia: Report of a case

Elenwo

Igwe

Jamabo

et al. 2016

International Journal of Surgery Case Reports

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“…In neglected Richter's hernia, the bowel perforation can also be associated with Fournier's gangrene. [2], [4] In females, inguinolabial Richter's hernia can present with spontaneous enterocutaneous faecal fistula. [5] Most of the strangulated small bowel needs resection and end-toend anastomosis.…”

Section: Discussionmentioning

confidence: 99%

“…Our initial diagnosis was scrotal abscess with funiculitis and Fournier's gangrene. [2] As the discharge was faecal smelling, a differential diagnosis of strangulated inguinal hernia was suspected preoperatively. Patient was kept nil by mouth and IV antibiotics, IV fluids were administered.…”

Section: Case Summarymentioning

confidence: 99%

Spontaneous Scrotal Enterocutaneous Fistula

Thulasivasudevaiah¹,

Asif²,

Shivakumar³

2016

jebmh

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BACKGROUND Management of strangulated inguinal hernias require resection of the gangrenous small bowel loops and end-to-end anastomosis. We are presenting a case of spontaneous scrotal faecal fistula due to strangulated Richter's hernia [1] where we have used a patch of tunica with scrotal inner layer to reinforce the perforated ileum. This procedure has avoided the resection of bowel and also we found useful alternative tissue instead of omental patch.

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Case Report: Fournier\'s gangrene complicating ruptured Richter\'s inguinal hernia

Cited by 6 publications

References 0 publications

A rare case of spontaneous inguinal faecal fistula as a complication of incarcerated Richter’s hernia with brief review of literature

A rare case of spontaneous inguinal faecal fistula as a complication of incarcerated Richter’s hernia with brief review of literature

Spontaneous entero-labial fistula complicating Richters hernia: Report of a case

Spontaneous Scrotal Enterocutaneous Fistula

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