Strangulated Femoral Hernia with Perforated Jejunal Pseudo Diverticulum: a Case Report
| Main Author: | Ekasaputra, Vito |
|---|---|
| Format: | Article info application/pdf Journal |
| Bahasa: | eng |
| Terbitan: |
Fakultas Kedokteran; Universitas Islam Sultan Agung (UNISSULA)
, 2018
|
| Subjects: | |
| Online Access: |
http://jurnal.unissula.ac.id/index.php/sainsmedika/article/view/2316 http://jurnal.unissula.ac.id/index.php/sainsmedika/article/view/2316/pdf |
Daftar Isi:
- Introduction: Sixty percent of femoral hernias are characterized by incarceration and strangulation. Jejunal pseudo diverticulum are rare and usually asymptomatic. It may cause chronic obstruction of small bowel and can lead to an acute perforation.Case presentation: An 85 – year – old woman presenting with 1 week history of generalized abdominal pain, with episodes of vomiting, fever, and history of 6 months of reponible femoral hernia and 2 weeks strangulated of femoral hernia. An abdominal X-ray displayed multiple dilated loops of the small bowel, coil spring sign and intra peritoneal free air. This patient underwent a laparotomy and hernioraphy, which identified single perforated jejunal pseudo diverticulum 50 cm from ligamentum of treitz orally from strangulated of ileal on femoral hernia site, and associated fecal contamination. The management for this case was perforation repaired with diverticulectomy, simple closure, and extensive washout of intraperitoneal cavity. The non tension femoral hernia repair was performed with monofilament, macroporous MESH.Conclusion: chronic intestinal obstruction caused by femoral hernia in the elderly can lead a performed of intestinal pseudo diverticulum and lead to significant morbidity and mortality. This could be suspected in those presenting with cramping abdominal pain and altered bowel habits.Keywords: hernia, femoral, strangulated, pseudo diverticulum, perforated, management
- Introduction : Femoral hernia is usually presented as a flexible, round, domed shape lying on the medial side of the thigh about 2 – 3 cm below the inguinal ligament. Among the external hernias, femoral hernia is the second most common inguinal hernia. It’s prevalence reaches 20 %. Among all inguinal hernias, femoral hernias are characterized by a high level of incarceration and strangulation. This can be as high as 60 %. Jejunal psudodiverticula are rare and are usually asymptomatic. It may cause by chronic obstruction of small bowel and can lead to an acute perforation.Case presentation : We report the case of an 85 – year – old woman presenting with 1 week history of generalized abdominal pain, with episodes of vomiting, fever, and history of 6 months of reponible femoral hernia and 2 weeks strangulated of femoral hernia. An abdominal X-ray displayed multiple dilated loops of the small bowel, coil spring sign and intra peritoneal free air. Our patient underwent a laparotomy and hernioraphy, which identified single perforated jejunal pseudodiverticula 50 cm from ligamentum og treitz orally from strangulated of ileal on femoral hernia site, and associated fecal contamination. The perforation was repaired with diverticulectomi, simple closure, and extensive washout of intraperitoneal cavity. We performed non tension femoral hernia repaired with monofilament, macroporous MESH.Conclusion : chronic intestinal obstruction caused by femoral hernia in the elderly can lead a performed of intestinal pseudodiverticula and lead to significant morbidity and mortality. This should be suspected in those presenting with crampy abdominal pain and altered bowel habits.