Abstract
A 60-year-old man, complaining of left groin swelling and pain, was transferred to our hospital. Abdominal computed tomography (CT) showed an incarcerated left inguinal hernia containing a sigmoid colon accompanied by subcutaneous air and feces. He underwent emergency operation immediately. The incision was made parallel to the left inguinal ligament, showing substantial subcutaneous feces and necrotizing tissues along the inguinal canal. A lower midline incision was added and the part of the sigmoid colon including a perforation site was resected, and the descending colon and the sigmoid colon were anastomosed using an ILS® 29mm. Intraoperative frozen section revealed perforated sigmoid colon cancer. The posterior wall of the inguinal canal was not able to be reinforced, instead four subcutaneous drains were placed around the inguinal wound. He suffered from severe SSI at the left groin, but was discharged on the 47th postoperative day. He has been treated with folinate / tegaful / uracil chemotherapy in our clinic.
Although incarcerated inguinal hernia accompanied by colon perforation rarely results from colon carcinoma, removing the perforation site and introducing appropriate wound drainage are likely to be indispensable.
