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Carcinoma of the sigmoid presenting as a right inguinal hernia

J L Boormans1, W L E M Hesp, T M Teune

  • 1Department of Surgery, Albert Schweitzer Hospital, P.O. Box 444, NL-3300, AK, Dordrecht, The Netherlands.

Hernia : the Journal of Hernias and Abdominal Wall Surgery
|September 1, 2005
PubMed

Insights

A rare case of sigmoid adenocarcinoma perforated through the groin is presented. This highlights the importance of considering colon cancer in patients with irreducible inguinal masses and fecal discharge.

Area of Science:

  • Gastroenterology
  • Surgical Oncology
  • Abdominal Imaging

Background:

  • Inguinal hernias are common surgical conditions.
  • Adenocarcinoma of the colon can present with unusual symptoms.

Observation:

  • A 44-year-old man presented with right inguinal pain, nausea, and vomiting.
  • Ultrasound suggested an incarcerated inguinal hernia; however, exploration revealed only necrotizing tissue.
  • The patient later developed fecal discharge from the inguinal wound, necessitating laparotomy.

Findings:

  • Laparotomy revealed a perforated, necrotic sigmoid colon.
  • Histological examination confirmed adenocarcinoma of the colon without lymph node metastasis.
  • The patient's presentation mimicked an incarcerated inguinal hernia but was caused by a perforated sigmoid adenocarcinoma.

Implications:

  • Incarcerated inguinal hernias containing colon adenocarcinoma are rare but must be considered.
  • Sigmoid carcinoma can invade the inguinal region, presenting as a palpable mass.
  • Intestinal perforation to the skin is an exceptionally rare and severe complication with high mortality.

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