Abstract
The case of a 63-year-old male, who had a 2-month history of black stool and who began having vomiting and diarrhea 2 days before visiting a nearby doctor, is described. Because of acute renal failure and increased systemic inflammation, he was referred to our hospital on the same day. Laboratory blood test results also showed hyperkalemia and an abnormal electrocardiogram due to hyperkalemia, for which immediate hemodialysis was performed. On admission, the physical examination showed a giant left inguinal hernia. On the seventh day of admission, exarcerbation of abdominal pain and tenderness of the left inguinal hernia appeared, so that computed tomography was done, which indicated perforation of the colon in the inguinal hernia. Emergency surgery was performed, and it revealed perforation in the incarcerated portion of the sigmoid colon and colon cancer. The operation involved hernia repair by left inguinal incision and the Hartmann procedure by midline incision. Since perforated colon cancer in an inguinal hernia sac is rare, this case is reported along with a review of the relevant literature.
