Inguinal Abscess in a Strangulated Littre's Hernia

MogrampiSaad, Al; KrexiAnastasia,; VerroiotouMaria,; PapoulidisNikolaos,; MichalakisDimitrios,; PolyzosApostolos,; FardellasIoannis,

doi:10.1089/crsi.2016.28999.sam

Cited by 1 publication

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“…After the initial reports of inguinal hernia sac abscesses following management of peritonitis by Cronin been reported. Other cases of hernia sac abscesses have been related to appendicitis, especially in the setting of Amyand or De Gargenot hernias [3][4][5][6][7], diverticular abscesses [8][9][10], Littre hernia [11], cancer [12], other colonic pathology [13], and even colorectal surgery [14]. Also, in an earlier era, several reports described cases in which a hernia sac abscess was identified before a diagnosis of generalized peritonitis was made [15][16][17][18], but this phenomenon may have been a result of the limitations of the diagnostic imaging modalities that were available at the time, and is not expected to persist in the modern era in which CT imaging enables surgeons to diagnose specific causes of peritonitis promptly.…”

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confidence: 99%

Inguinal Sac Abscess Masquerading as a Strangulated Inguinal Hernia after Antrectomy and Proximal Duodenectomy for Perforated Peptic Duodenal Ulcer

LiMichael

SarkarBedabrata

Kofi

et al. 2017

Surgical Infections Case Reports

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Background: Patients who undergo surgery for a perforated duodenal ulcer are at risk of developing an intraabdominal abscess. Even in this setting, the possibility of developing an inguinal hernia sac abscess is rare. Case Presentation: We report the case of a 66-year-old male who underwent an antrectomy and proximal duodenectomy, truncal vagotomy, Billroth II gastrojejunostomy, and a Witzel tube jejunostomy for a recurrent perforated duodenal ulcer. Seven days after this operation, he developed symptoms concerning for a strangulated left inguinal hernia. At operation, a hernia sac abscess of Candida glabrata was identified and excision of the hernia sac and McVay herniorrhaphy were performed. Conclusion: An inguinal sac abscess may develop in patients who have undergone surgery for perforated peptic ulcers and can masquerade as a strangulated inguinal hernia. In the post-operative period, it should be considered in patients who develop an acute onset of groin pain. Definitive management should include excision of the sac and herniorrhaphy without a mesh prosthesis to limit the risk of a chronic wound infection.

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