Rare cause of gastric outlet obstruction: incarcerated pylorus within an inguinal hernia

Abstract

We present the case of a 79-year-old man admitted to the emergency room. Having anorexia and vomiting as main complaints, combined with abdominal distension and discomfort, diagnostic examination revealed a giant left inguinal hernia containing the antrum and pylorus of a dilated stomach, creating an outlet obstruction. This was complicated with free peritoneal air, gastric emphysema and air in the portal system due to ischaemia.

Emphysematous Gastritis and Gastric Emphysema: Similar Radiographic Findings, Distinct Clinical Entities

“…Dead (different etiology) Lowe et al [50] Repositioned stent Duodenal perforation by biliary stent migration Alive Badrinath et al [51] No Acute gastric dilatation from druginduced gastritis Alive Hadas-Halpren et al [52] Exploratory laparotomy Acute gastric dilatation Alive Chintapalli [53] No Gastric bezor Alive Low VH et al [54] Total gastrectomy, esophagojejunal anastomosis Acute massive gastric distention Dead Omojola et al [55] No/no/subtotal gastrectomy Obstruction secondary to gastric cancer/ obstruction secondary to gastric cancer/ obstruction secondary to gastric cancer Alive/alive/alive Ulloa Ramirez et al [56] Exploratory laparotomy, lysis of adhesion Small bowel obstruction Alive Millward et al [57] Exploratory laparotomy Colonic infarction NA Sproat et al [58] No Balloon dilation of esophageal stenosis Dead (different etiology) Soon et al [59] No Biliary stenting and duodenal obstruction Dead (different etiology) Zenooz et al [60] Lysis of adhesion Gastric distension from small bowel obstruction Alive Kalina M, et al [61] No Gastric distension Alive Moon SW, et al [62] No Methyl ethyl ketone peroxide ingestion Dead Barbour et al [63] No Unknown Alive Chou et al [64] No Nausea, vomiting, mucosal damage by chemo therapy? Alive Muthukumarasamy, G et al [7] No Gastric outlet obstruction Dead (different etiology) Reuter et al [65] No Distension of the stomach during CPR NA Hyun et al [66] No Endoscopic submucosal dissection Alive Chang et al [67] No Increased gastric intraluminal pressure Dead (different etiology) Cherian et al [68] No Diabetic gastroparesis, vomiting Alive Majumder et al [8] No Retching, vomiting Alive Kerschaever et al [69] No Incarcerated stomach in inguinal hernia Alive Ilyas et al [70] Parastomal hernia repair Incarcerated stomach in parastomal hernia Alive including nausea, vomiting, epigastric abdominal pain, distension, or tenderness without evidence of peritonitis and is found by plain film or CT scan to have evidence of intramural air in stomach. Initial interventions should include bowel rest with nasogastric tube placement, appropriate hemodynamic monitoring, fluid resuscitation, and broad-spectrum antibiotics to cover gram negatives and anaerobes.…”

Novel treatment of gastric outlet obstruction secondary to incarcerated inguinal hernia: percutaneous endoscopic gastrostomy tube

“…Surgical hernia repair is the standard definitive treatment to avoid complications from hernias such as this [ 7 , 8 ]. These complications include recurrent GOO, strangulated bowel and gastric perforation in the incarcerated inguinal hernia [ 9 , 10 ]. However, not every patient is willing or able to be a surgical candidate.…”

Duodenal rupture due to giant inguinal hernia: A case report

“…A number of intraabdominal organs have been reported in giant inguinal hernias including the appendix, bladder, small and large bowel, stomach, and ovaries [3] . There are some reported cases of gastric, small bowel, or colon perforation due to inguinal hernia [3] , [5] , [6] , [7] , [8] , [9] . However, duodenal rupture due to inguinal hernia is rarely reported.…”