Abstract
A 76-year-old woman was admitted with epigastric pain. A left inguinal mass was detected. Abdominal X-ray showed marked intestinal dilation, and bowel obstruction due to an incarcerated left inguinal hernia was diagnosed. After manual reduction, she was admitted. The following day, the bowel obstruction had not improved. Enhanced computed tomography showed intestinal prolapse into the right sciatic foramen. Bowel obstruction due to an incarcerated right sciatic hernia was diagnosed, and emergency surgery was performed. Laparoscopy showed a right sciatic hernia, and the hernia had already reduced spontaneously. Bloody ascites was seen, and intestinal necrosis was suspected. The operation was converted to open laparotomy, but there was no intestinal necrosis. The hernia orifice was closed by suturing the right ovary and surrounding tissues. The patient was discharged on the 35th postoperative day, with prolonged hospitalization due to pneumonia. When an incarcerated abdominal hernia is found, careful observation after the reduction is important to diagnose other possible hernias. Enhanced computed tomography and laparoscopy are useful for diagnosis and treatment.
