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Gangrenous Richter's hernia with intrasac abscess
K Bhattacharya1, R Ramakrishnan, T R Gopalan
1Department of Surgery, Sri Ramachandra Medical College & Research Institute, Chennai-600 116. kaushik_srmc@rediffmail.com
Tropical Gastroenterology : Official Journal of the Digestive Diseases Foundation
|July 2, 2003
Summary
A rare case of strangulated Richter's hernia occurred in an incisional hernia from a previous C-section scar. This condition, involving an abscessed hernia sac, required surgical resection and anastomosis.
Area of Science:
- Gastroenterology
- Surgical Case Reports
- Abdominal Wall Surgery
Background:
- Richter's hernia is a rare form of strangulated hernia, accounting for 8.3% of all strangulated hernias.
- Previous reports of strangulated Richter's hernia have involved inguinal, femoral, and port hernias.
- Incisional hernias can develop at surgical sites, particularly following abdominal procedures like Cesarean sections.
Observation:
- A 43-year-old female presented with symptoms of intestinal obstruction.
- Laparotomy revealed a strangulated Richter's hernia with an abscess within an incisional hernia sac.
- The incisional hernia was located at the scar of a previous lower segment Cesarean section.
Findings:
- The patient was diagnosed with a strangulated Richter's hernia within an incisional hernia sac.
- Surgical intervention included resection and anastomosis to address the strangulated bowel segment and abscess.
- This represents the first reported case of strangulated Richter's hernia occurring in an incisional hernia.
Implications:
- This case highlights the potential for Richter's hernia to occur in incisional hernias, a previously unreported location.
- Accurate diagnosis and prompt surgical management are crucial for favorable outcomes in strangulated abdominal hernias.
- Further investigation into the specific risk factors and management strategies for Richter's hernia in incisional hernias may be warranted.