Related Experiment Videos
[A strangulated perineal hernia. A rare case of intestinal obstruction]
P Sciacca1, R Bertolini, M Borrello
1Divisione di Chirurgia Generale Urgenza e Pronto Soccorso, Azienda Ospedaliera S. Camillo-Forlanini, Roma.
Abstract:
A rare case of intestinal obstruction due to strangulated perineal hernia, observed among 533 small bowel obstructions operated since January 1982 until December 1994 (0.2%) is described. Less than 100 cases are reported in literature. The etiologic, anatomical and clinical aspects of perineal hernia are examined. The reported case is of the primitive, congenital type caused by defect of the rectovaginal fascia fusion, in correspondence of the Douglas. Preoperative diagnosis is very difficult. Strangulation of this type of hernia is rare, the hernial sac surrounding tissue being elastic. In case of strangulation, symptoms of intestinal obstruction appear. In the reported case the preoperative diagnosis was "acute abdomen", because there was defence in hypogastrium and in the right iliac fossa. A straight abdominal radiography has not been performed. In the reported case the patient, a 22-year-old woman, was promptly operated and the incarcerated intestinal loop released. A regular postoperative period followed. The importance of a complete clinical examination, of a straight abdominal radiography and of a promptly performed operation is underlined.
Insights
A rare case of strangulated perineal hernia causing intestinal obstruction is presented. Prompt surgical intervention is crucial for favorable outcomes in these infrequent cases.
Area of Science:
- Gastroenterology
- Surgical Pathology
Background:
- Perineal hernias are rare, with fewer than 100 cases reported in medical literature.
- This study details a rare instance of intestinal obstruction caused by a strangulated perineal hernia.
Observation:
- The case involved a 22-year-old female with a congenital perineal hernia due to rectovaginal fascia defect.
- Preoperative diagnosis was challenging, with symptoms mimicking "acute abdomen".
Findings:
- The patient presented with symptoms of intestinal obstruction due to a strangulated perineal hernia.
- Surgical release of the incarcerated intestinal loop resulted in a regular postoperative recovery.
Implications:
- Highlights the diagnostic difficulty of perineal hernias, especially when strangulated.
- Emphasizes the importance of thorough clinical examination, abdominal radiography, and timely surgical intervention for successful management.