Abstract
A 91-year-old woman who was referred to our hospital with a diagnosis of intestinal obstruction was performed surgery through the femoral method for right incarcerated femoral hernia, but her symptoms of intestinal obstruction persisted even after the surgery. Abdominal CT scan failed to disclose significant findings indicating causes of intestinal obstruction. Placement of an ileus tube was unsuccessful in improving intestinal obstruction. We thus performed laparotomy and identified a state in which the small intestine seemed to have been impacted into the pelvic wall that was similar to reduction en masse.
Few cases of reduction en masse have been reported so far, most of which occurred when manual reduction was employed for incarcerated inguinal hernias. In this case, bowel incarceration at the femoral ring was difficult to be released in the surgery for incarcerated femoral hernia and similar state to reduction en masse occurred when the herniated small intestine was reduced to the abdominal cavity. The femoral method is a minimally invasive procedure that can be done under local anesthesia. However, when the incarceration is not easily reduced by the femoral method, a change of it to other method should also be considered.
