Abstract
Reduction en-masse of femoral hernia involves reduction of the hernial sac together with the incarcerated bowel into the preperitoneal space. It is a rare cause of acute intestinal obstruction. We report the case of a 100-year-old woman who underwent reduction en-masse of a femoral hernia. She was referred to our hospital because of persistent intestinal obstruction after manual reduction of hernia. Her abdomen was distended and she experienced tenderness at the right inguinal area without a palpable mass. A computed tomography scan showed small-bowel obstruction, ascites, and caliber change at the right inguinal area. Preoperative diagnosis was small-bowel incarceration caused by femoral hernia, with secondary bowel obstruction. We performed an emergency operation and detected incarceration of the small bowel into the preperitoneal space, and not into the femoral ring, covered with the hernial sac. We also observed that the intestine was strangulated by a hypertrophic peritoneum. We repaired the femoral hernia by using a polypropylene mesh. Reduction en-masse of femoral hernia has not been reported in Japan. Here, we have reviewed previously published reports on reduction en-masse of inguinal hernia and discussed the anatomical and clinical aspects of this condition.
