Abstract
An 82-year-old man with a 20-year history of a bulge in the left inguinal region was admitted to our hospital because of vomiting and abdominal pain which occurred, three days after he lost his appetite. On admission, tenderness and muscular guarding were observed in the left lower quadrant of abdomen. Swelling, tenderness, and redness were marked from the left inguinal region to the scrotum. Abdominal CT scan revealed free air in the abdominal cavity, and an incarcerated sigmoid colon and feces in the left scrotum. We diagnosed the case as generalized peritonitis caused by a perforation of the sigmoid colon in the left incarcerated inguinal hernia, and performed an emergency laparotomy. Operative findings showed generalized peritonitis due to leakage of intestinal contents into the peritoneal cavity caused by the perforation of the sigmoid colon in the incarcerated indirect inguinal hernia. Hartmann's procedure and the resection of the hernial sac were performed. The patient was discharged from the hospital on postoperative day 29.
A case of a perforation of the sigmoid colon, without organic disease, by an incarcerated inguinal hernia is extremely rare. The present case is reported with reference to the literature.
