Laparoscopic Surgery for Cecal Incarceration of Inguinal Hernia with a Scrotal Abscess：A Case Report

Abstract

A 92-year-old man visited our hospital with the chief complaint of swelling and hardness in the right inguinal region and pus discharge from the right scrotum. Based on the findings of detailed examination, we made the diagnosis of cecal incarceration of right inguinal hernia with a scrotal abscess. Extensive subcutaneous inflammatory thickening was noted in the area extending from the right inguinal region to the scrotum, but as there was no evidence of intraperitoneal inflammation, we selected laparoscopic surgery. Because the incarcerated cecum was found to be perforated, we performed ileocecal resection. On the other hand, the inguinal region was highly inflamed and highly sclerosed, so that simultaneous repair of the inguinal hernia was judged as being difficult, and we did not perform single-stage repair of the inguinal hernia. The patient developed postoperative wound infection, requiring incisional drainage of the wound, and was discharged on the 16th day. The scrotal abscess healed spontaneously by about 3 months after surgery. Until now, 6 months after the surgery, the patient has developed no recurrence of the scrotal abscess or hernia incarceration. In cases of ileocecal incarceration of inguinal hernia with a scrotal abscess, surgery by the laparoscopic approach could be considered as a treatment option if the inflammation is confined to the inguinal area or the scrotum.