Garré stricture: An unusual cause of intestinal obstruction: A case report

Garré stricture is a very rare complication post-reduction of a strangulated hernia before gangrene, first described in 1892. Diagnosis poses difficulty without a proper history and information about the prior interventions.

A 50-year-old lady with a groin swelling for two years, diagnosed with an obstructed femoral hernia, underwent trans-inguinal exploration under spinal anesthesia and discharged on the 4th post-operative day after an uneventful postoperative period. The patient again presented on the 21st post-operative day with features of intestinal obstruction and underwent emergency laparotomy on the 3rd day of second admission for complete bowel obstruction. Intraoperative diagnosis was Garré stricture, and resection of the ileal stricture with ileo-ileal anastomosis was done and discharged on the 12th post-operative day without any complications, and further follow-up was uneventful.

First noticed by Richter in 1782 and later described by Garré in 1892 after literature review. If blood supply is restored after manual or surgical reduction of bowel in a strangulated hernia, before the critical time of ischemia may lead to mucosal ulceration and sub-mucosal fibrosis, which can lead to fibrosis of the strangulated segment. These patients may present with features of intestinal obstruction caused by the stricture segment requiring surgical intervention.

Among complications of groin hernia, Garré stricture is rarely encountered. It can be cause of intestinal obstruction, especially in post-reduction cases of groin hernia. So, knowledge about this rare complication is very beneficial in the management of strangulated hernia and its future complications.