Trauma to an inguinal hernia resulting in bowel rupture: A case report and literature review

We report on a rare case of a man with bowel rupture due to direct trauma to his diagnosed inguinal hernia, with reviewing the relevant literature, we have found some characteristics of our case different from the similar cases reported by other authors.

A 54-year-old man, with a dignosed right inguinal hernia without treatment for over six months, presented to our hospital with generalized peritonitis and possible sepsis, caused by minimal hit directly to his hernia. The patient underwent an immediate exploratory celiotomy with segmental intestine resection and anastomosis, without hernia repair at the same time because of the concomitant peritonitis. The patient recovered uneventfully and postoperative histology showed chronical inflammation of the perforated bowel. Later, he patient had his hernia repaired by elective operation.

Different from other cases of the same kind, our patient only suffered a trivial blunt trauma, so we believe that the longlasting inflammation of the intestine is one of the major reasons for such a bowel perforation, which differs from the opinion that external force is the crucial factor. Besides, after the first non-herniorrhaphy procedure, our patient kept no recurrent hernia for about 10 months until it's recurrence and had the herniorrhaphy.

Trauma directly to a known inguinal hernia is an uncommon, but a dangerous event, and the abnormal alterations of intestine in the hernial sac may be one of the major reasons for such event, so it is mandatory for the physician to explain the complication of the hernia to the patient, for the hernia being repaired as early as possible.