Abstract
We report a rare case of Richter's type strangulated femoral hernia containing the cecum. A 78-year-old male presented with a bulge and pain in the right groin. On the following day, he was admitted to our department. Physical examination revealed a mass, 3cm in diameter, just caudal side of the right inguinal ligament. Computed tomography revealed a strangulated right femoral hernia ; however, there were no signs of bowel obstruction. He underwent an emergency operation and a right inguinal incision was made. The omentum and part of the cecal wall were found in the hernia sac with strangulation. Richter's type strangulated femoral hernia was diagnosed. Ischemic necrosis of the cecal wall was suspected. A lower midline incision was added, followed by partial resection of the cecum and tension-free inguinal mesh repair using the PROLENE Hernia System. The patient required treatment for midline wound infection postoperatively but was discharged 20 days after the operation, without having inguinal wound or mesh infection. Establishing an early diagnosis of Richter's hernia without bowel obstruction is challenging. Further discussions are warranted to determine the safety of using a mesh insertion in patients with strangulated femoral hernia in whom intestinal resection is performed.
